The prevalence and effect of publication bias in orthopaedic meta-analyses.

Meta-analyses of randomized, controlled trials are considered the highest level-of-evidence, thus strongest source of information. However, questions concerning the validity of meta-analyses in orthopaedic surgery emerged recently. Among the most common sources for errors is publication bias. This describes the fact that studies with small or non-significant outcomes are less likely to be published, thus less likely to be identified and included in systematic reviews and meta-analyses. In this study we asked three questions: (1) Whether publication bias is assessed in orthopaedic meta-analyses, (2) What the actual prevalence of publication bias is, and (3) what effect publication bias has on the outcomes of orthopaedic meta-analyses.  Vavken P, Dorotka R. J Orthop Sci. 2011 Mar;16(2):238-44. Epub 2011 Mar 2. PMID: 21360256