RT Journal
A1 Annane D
T1 COrticosteroid therapy for severe sepsis and septic shock—reply
JF JAMA
JO JAMA
YR 2009
FD October 21
VO 302
IS 15
SP 1643
OP 1645
DO 10.1001/jama.2009.1482
UL http://dx.doi.org/10.1001/jama.2009.1482
AB 
The potential sources of an asymmetrical funnel plot include selection biases, poor methodological quality of smaller studies, true heterogeneity, artifacts, or chance.1 Visual inspection of the funnel plot suggests a small-study effect (ie, among small studies the positive ones are more likely to be published). Nevertheless, our thorough search strategy and the need to enroll studies in public clinical trial registries may have decreased the risk of missing any randomized control trial. As discussed in the review, all studies on low-dose corticosteroids had acceptable methodological quality.