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If publication bias was suspected, results are shown without imputation and with "missing" studies imputed with Duval and Tweedie's trim and fill method.
There were no missing studies imputed in regions of the contour enhanced funnel plots.
Furthermore, the addition of four "missing" studies imputed using the trim and fill method (white circles in fig 3) reduced the magnitude of the pooled effect size and shifted it closer to zero (adjusted standardised mean difference −0.01, 95% CI −0.08 to 0.06).
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Imputing missing studies restores the symmetry in the funnel plot and an adjusted effect size can be calculated.
The trim-and-fill method was used to impute missing studies if there was evidence of asymmetry of the funnel.
The mean effect sizes of psychological well-being and depression were therefore recalculated by imputing missing studies using the Trim and Fill method.
This method considers the possibility of hypothetical "missing" studies that might exist, imputes their RRs, and recalculates a pooled RR that incorporates the hypothetical missing studies as though they actually existed.
For more specific evaluation of the presence and extent of publication bias we used the non-parametric trim and fill method according to Duval and Tweedie, 51 which imputes missing studies in the funnel plot based on symmetry assumptions.
The Duval and Tweedie trim and fill method imputed two missing studies, resulting in a slightly higher revised estimate of 2.84 (95% confidence interval 1.41 to 5.72; P=0.004).
The Duval and Tweedie's Trim and Fill method was used to impute 5 missing studies and estimate RR as 1.47 (1.47–1.47).
The trim-and-fill method imputed 2 hypothetically missing studies, slightly attenuating the risk.
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CEO of Professional Science Editing for Scientists @ prosciediting.com