Performance of the trim and fill method in the presence of publication bias and between‐study heterogeneity

The trim and fill method allows estimation of an adjusted meta-analysis estimate in the presence of publication bias. To date, the performance of the trim and fill method has had little assessment. In this paper, we provide a more comprehensive examination of different versions of the trim and fill method in a number of simulated meta-analysis scenarios, comparing results with those from usual unadjusted meta-analysis models and two simple alternatives, namely use of the estimate from: (i) the largest; or (ii) the most precise study in the meta-analysis. Findings suggest a great deal of variability in the performance of the different approaches. When there is large between-study heterogeneity the trim and fill…