GRADE方法中，随机试验起评即为高质量证据，观察性研究起评即为低质量证据；但若证据本身存在高发表偏倚风险，则两者证据质量级别都应降低。即使最佳证据汇总表纳入的各项研究仅有低发表偏倚风险，发表偏倚仍会极大高估效应值。当可得证据来自小样本研究、且多数由厂商资助时，作者应怀疑存在发表偏倚。若干基于检验数据类型的方法可用于评价发表偏倚，其中最常用的为漏斗图，但这些方法都有较大局限。发表偏倚可能较常见，必须特别关注早期结果、对样本量与事件数都很小的早期试验结果尤需小心。
Citation： . GRADE guidelines: 5. Rating the quality of evidence—publication bias△. Chinese Journal of Evidence-Based Medicine, 2011, 11(12): 1430-1434. doi: 10.7507/1672-2531.20110242 Copy
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