Please note that the content of this book primarily consists of articles available from Wikipedia or other free sources online. A funnel plot is a useful graph designed to check the existence of publication bias in meta-analyses. Funnel plots, introduced by Light and Pillemer in 1984 and discussed in detail by Egger and colleagues, are useful adjuncts to meta-analyses. A funnel plot is a scatterplot of treatment effect against a measure of study size. It is used primarily as a visual aid to detecting bias or systematic heterogeneity. A symmetric inverted funnel shape arises from a ‘well-behaved’ data set, in which publication bias is unlikely. An asymmetric funnel indicates a relationship between treatment effect and study size. This suggests the possibility of either publication bias or a systematic difference between smaller and larger studies. Asymmetry can also arise from use of an inappropriate effect measure. Whatever the cause, an asymmetric funnel plot leads to doubts over the appropriateness of a simple meta-analysis and suggests that there needs to be investigation of possible causes.

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