Why the study?
Funnel plots detect small-study effects in univariate meta-analyses, but no counterpart visualization tool exists for the multivariate setting.
The galaxy plot provides a novel visualization method for detecting small-study effects in bivariate meta-analyses, analogous to funnel plots in univariate settings.
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Galaxy plots enhance detection of small-study effects in bivariate meta-analyses; extends univariate funnel plots to joint outcome distributions.
Funnel plots have been widely used to detect small-study effects in the results of univariate meta-analyses. However, there is no existing visualization tool that is the counterpart of the funnel plot in the multivariate setting. We propose a new visualization method, the galaxy plot, which can simultaneously present the effect sizes of bivariate outcomes and their standard errors in a 2-dimensional space. We illustrate the use of the galaxy plot with 2 case studies, including a meta-analysis of hypertension trials with studies from 1979-1991 (Hypertension. 2005;45(5):907-913) and a meta-analysis of structured telephone support or noninvasive telemonitoring with studies from 1966-2015 (Heart. 2017;103(4):255-257). The galaxy plot is an intuitive visualization tool that can aid in interpreting results of multivariate meta-analysis. It preserves all of the information presented by separate funnel plots for each outcome while elucidating more complex features that may only be revealed by examining the joint distribution of the bivariate outcomes.
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Hong et al. (2019) studied this question.
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