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. 2017 Nov 10;7:15323. doi: 10.1038/s41598-017-14917-5

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© The Author(s) 2017

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

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Funnel plots was applied to assess publication bias which were plotted in the log risk ratios against their standard errors and estimating the number of missing studies that might exist in a meta-analysis and the effect that these studies might have had on its outcome. (a) Funnel plot with 95% confidence limits for testing publication bias; (b) Funnel plot of all studies with 95% CI, including hypothetical studies using ‘trim and fill’ method (in red) for adjusting publication bias. After adjusting for missing studies, we noted that the point estimate of the overall effect size is approximately correct and coverage of the effect size confidence intervals is substantially improved. The results showed that publication bias or another confounding variable should be considered, but would not be a major influencing factor for the intervention effect. That is, the publication bias did not affect our major outcomes.