What is already known

• • Data visualization enhances meta-analysis, aiding in identifying patterns and increasing the accessibility of evidence to end-users in science, policy, and practice.

• • Quantitative information in meta-analyses is commonly presented through user-friendly formats, such as forest plots and funnel plots, with effect size estimates and precisions.

• • Meta-analyses include qualitative information on study characteristics and bibliographic attributes, which are rarely visualized.

What is new

• • Integrating the elements of scoping reviews and bibliometrics into meta-analyses enriches research synthesis by visualizing qualitative evidence.

• • Scoping reviews (systematic mapping) can enhance meta-analyses by providing a user-friendly summary of study characteristics and identifying knowledge gaps and gluts.

• • Bibliometric analysis can visualize nonindependent evidence, revealing dominant authors and countries, informing potential risk of bias (RoB).

• • Further, alternative impact metrics, such as Altmetric attention scores, patents, and policy citations, can help capture the societal impacts of meta-analyses beyond academia.

Potential impact for RSM readers

• • The proposed visualization toolkits transform qualitative information into easily digestible formats for end-users, requiring minimal additional data extraction effort from meta-analysts.

• • The proposed visualization toolkits’ capacity can be extended to other methods in research synthesis ecosystems, such as the systematic-review family, review-of-review family, and rapid-review family, to convey quantitative information in a user-friendly manner for every evidence base.

3.1 Rationale

Evidence maps (scoping reviews) represent a form of research synthesis approach that systematically collates and catalogs existing evidence on a specific topic, yet is broader than a systematic review.Reference Munn, Pollock and Khalil ³⁶ While similar approaches exist with varying terminologies, such as mapping reviews, systematic evidence maps, and evidence and gap maps,Reference Khalil and Tricco ^{21 –} Reference Haddaway, Bernes, Jonsson and Hedlund ^{23 ,} Reference Alahdab and Murad ^{25 ,} Reference Saran and White ^{37 ,} Reference Campbell, Tricco and Munn ³⁸ here we treat them as synonyms because they share a common core feature: mapping the state of the evidence, which makes them valuable for meta-analysis enrichment. We use the term “evidence mapping,” defining it as a process that employs various visualization methods to provide a user-friendly summary of study characteristics (qualitative evidence) within a meta-analysis (the end-product).Reference Snilstveit, Vojtkova, Bhavsar, Stevenson and Gaarder ^{16 ,} Reference Chen, Takwoingi and Grove ²² Incorporating evidence mapping into a meta-analysis offers two benefits. First, it inherits the merits of a conventional evidence map, such as identifying knowledge gaps, directing research priorities, and providing support for funding and policy decisions.Reference Snilstveit, Vojtkova, Bhavsar, Stevenson and Gaarder ^{16 ,} Reference Alahdab and Murad ²⁵ Second, evidence mapping can inform methodological decisions (e.g., post hoc analyses) and interpretations of meta-analytic findings. Various visualization approaches exist, such as heatmap and bubble plotsReference Haddaway, Feierman and Grainger ³⁹ and other displays used in the 3ie Evidence Gap Map (https://www.3ieimpact.org/evidence-hub/evidence-gap-maps)Reference Snilstveit, Vojtkova, Bhavsar, Stevenson and Gaarder ¹⁶ and Evidence-based Policing Matrix (https://cebcp.org/evidence-based-policing/the-matrix/),Reference Lum, Koper and Telep ⁴⁰ for mapping the evidence landscape.

We recommend using grid-like graphs, where one dimension (e.g., intervention) is placed on the x-axis, and the other (e.g., outcomes) is placed on the y-axis, with statistics (e.g., the number of studies, number of effects, sample size) displayed at the intersection of the x- and y-axes.Reference Polanin, Zhang, Taylor, Williams, Joshi and Burr ¹⁸ Additional dimensions, such as study design, effect size, study quality, or RoB measures, can also be incorporated (see more on this point in the next section). We recommend using alluvial or Sankey diagrams to visualize the flow or overlaps in the composition of context-dependence drivers, summarizing their connections and co-linearity, and missing data patterns in an accessible manner. Additionally, a geographical map of study participants could reveal the representation status of historically underrepresented regions or groups, by incorporating location, gender, ethnic, or social backgrounds into visualizations. Understanding such patterns, in turn, can facilitate actions toward greater equity, diversity, and inclusion (EDI) in research. For phylogenetic meta-analytic analyses, visual representation of species information, such as species phylogenetic trees, can intuitively convey the breadth of taxa and underlying phylogenetic heterogeneity.

3.2 Case studies

We demonstrate the application of evidence mapping using three publicly available meta-analytic datasets (Data 1 to Data 3) from various disciplines.Reference Hodkinson, Bower and Grigoroglou ^{41 –} Reference Sanders, Frago, Kehoe, Patterson and Gaston ⁴³ Note that these applications are provided for illustrative purposes, and any scientific, clinical, or policy implications should not be drawn from them. The data and code for replicating all visualizations can be found at https://yefeng0920.github.io/MA_Map_Bib/.

Data 1: Hodkinson et al.Reference Hodkinson, Bower and Grigoroglou ⁴¹ conducted a network meta-analysis (including 68 studies and 80 effect size estimates) to assess the efficacy of different self-management interventions (multidisciplinary case management, regularly supported self-management, and minimally supported self-management) in enhancing the quality of life among asthma patients.

Data 2: Mertens et al.Reference Mertens, Herberz, Hahnel and Brosch ⁴² employed a multilevel meta-analytic model to synthesize evidence (including 212 studies and 447 effect size estimates) on the effectiveness of choice architecture interventions (often referred to as nudges) for behavior change across various techniques, behavioral domains, and other study characteristics (e.g., populations and locations).

Data 3: Sanders et al.Reference Sanders, Frago, Kehoe, Patterson and Gaston ⁴³ used a Bayesian meta-analytic model to synthesize evidence (including 126 studies and 1,304 effect size estimates) regarding the impacts of artificial light at night on physiological, phenological, life history, activity patterns, and population/community-based outcomes. This meta-analysis included more than 180 species. For illustration, we used the subset that focused on physiological outcomes.

Evidence maps (scoping reviews) often use structured formats to map the evidence of a given field, such as participant, context, concept (PCC) and units, treatments, outcomes, or settings (UTOS).Reference Polanin, Zhang, Taylor, Williams, Joshi and Burr ^{18 ,} Reference Khalil and Tricco ²¹ For Data 1, we used grid-like graphs with the intervention variable on the x-axis and the outcome variable on the y-axis.Reference Polanin, Zhang, Taylor, Williams, Joshi and Burr ¹⁸ This aimed to identify knowledge gaps in self-management interventions. Each cell displayed two statistics: the number of studies and the number of effect sizes. We further quantified the population mean effect size estimate for each cell using a robust point and variance estimation approach.Reference Yang, Lagisz, Williams, Noble, Pan and Nakagawa ⁴⁴ For Data 2, we utilized an alluvial diagram to illustrate the connections (collinearities) between moderator variables related to the hypotheses tested. Data 3 featured a phylogenetic tree to visualize the taxonomic breadth and relatedness among the species involved. Data processing and visualizations were conducted using packages ggplot2,Reference Wickham, Chang and Wickham ⁴⁵ ape,Reference Paradis, Claude and Strimmer ⁴⁶ ggtree,Reference Yu, Smith, Zhu, Guan and Lam ⁴⁷ and metafor. Reference Viechtbauer ⁴⁸

3.3 Results and discussion

Figure 2 shows the landscape of evidence on the effectiveness of the self-management interventions in Data 1. For example, panels (a) and (b) visually represent where randomized controlled trials (RCTs) are available to examine the interventions’ effectiveness, offering insights into which interventions have received more clinical attention. Panel (c) conveys critical information about both which interventions have been examined in the RCTs and their associated effectiveness. Panel (d) reveals a potential demographic bias, as most self-management interventions were trialed on adults. This information can inform funding strategies (e.g., funding missing RCTs, or in-depth investigation) and help clinicians gauge the volume and effectiveness of their interventions of interest.

Figure 2

Examples of evidence maps visualizing study characteristics. (a) A typical grid-like graph with the intervention variable as the first dimension, the outcome variable as the second dimension, and the bubble size representing the number of studies. (b) The bubble sizes are changed to represent the number of effect sizes. (c) The color scale is applied to the bubbles to denote the magnitude of the overall mean effect size. Note that the application of Figure 2 requires that outcomes and interventions (or any other two variables reflecting study characteristics) could be categorized into different levels via moderators, as shown in Figure 2. Hedge’s g was used as the effect size measure to quantify mean differences in outcomes between an intervention and a control group. A multivariate fixed effect model was used to derive the overall average effect of each paired combination of intervention and outcome type.Reference Yang, Lagisz, Williams, Noble, Pan and Nakagawa ⁴⁴ (d) The population variable is mapped to the shape serving as the third information dimension. The full names of different types of interventions are as follows: CM = case management, ISM = intensive self-management, PSM = pure self-management, SSM = support self-management. The full names of different types of outcomes are as follows: SGRQ = St Georges Respiratory Questionnaire, QoL = Quality of Life Scale, PedsQL = Pediatric Quality of Life Inventory Generic Core Scales, PAQLQ = Pediatric Asthma Quality of Life Questionnaire, PACQLQ = Pediatric Asthma Caregiver’s Quality of Life Questionnaire, AQoL = Assessment of Quality of Life, and AQLQ = Asthma Quality of Life Questionnaire. For the details of the interventions and outcomes, refer to the original paper.Reference Hodkinson, Bower and Grigoroglou ⁴¹ R code was adapted from Polanin et al.Reference Polanin, Zhang, Taylor, Williams, Joshi and Burr ¹⁸

Figure 3 highlights the diversity of experimental designs in the primary studies included, suggesting potential heterogeneity in the meta-analytic evidence in Data 2. The tested moderator variables display minimal collinearity, indicating that each variable represents a unique contextual influence. Importantly, Figure 3 provides useful visual clues to identify the contexts requested by decision-makers, facilitating the assessment of the effectiveness of interventions in the context of interest (e.g., target population and location). A follow-up customizable evidence synthesis can be conducted to improve the generalizability and transferability of meta-analytic evidence (see Reference Martin, Christie and Shackelford ¹⁷ for more details).

Figure 3

An example of an alluvial diagram showing the overlaps in the composition of moderator variables considered as potential context-dependence drivers of effect sizes in a meta-analysis.

Figure 4 presents a typical phylogenetic tree revealing the broad coverage of taxa used in artificial light at night experiments, including birds, mammals, insects, reptiles, and arachnids in Data 3. For a more in-depth statistical analysis, constructing a phylogenetic correlation matrix can quantify the effect of the shared evolutionary history among species in the meta-analytic evidence base.

Figure 4

An example of a phylogenetic tree visualizing the breadth of taxa and underlying phylogenetic heterogeneity. The effect size estimates for each species were weighted based on the inverse of the sampling variance–covariance matrix. Confidence intervals for each species were constructed using a Ward-type approach, with standard errors as the square root of the sampling variance of the weighted mean. For simplicity, we assumed a sampling correlation of 0.5 for the calculation of confidence intervals (the actual correlation should be informed from ancillary data or guesstimates by domain experts). The dot represents the average mean effect size of each species. The whisker represents the 95% confidence interval. Different colors represent different phylogenetic classes. We approximated the branch lengths of the phylogenetic tree, using the Grafen method, setting the power parameter of 1 to adjust the “height” of branch lengths at the tips of the phylogenetic tree. The correlation matrix of the phylogenetic tree was estimated, assuming that the evolution of the trait follows the Brownian motion.

4.1 Rationale

Bibliometric analysis, often called bibliometrics, is a technique that effectively synthesizes bibliometric data to provide an overview of the performance and intellectual structure of a field.Reference Donthu, Kumar, Mukherjee, Pandey and Lim ⁴⁹ It holds a unique position in the research synthesis method ecosystem because it synthesizes the bibliometric characteristics (literature metadata, not research content),Reference Nakagawa, Samarasinghe and Haddaway ²⁶ such as authors, countries, funders, and citation counts.Reference Godin ⁵⁰ Literature-level characteristics are to scientific papers as epidemiology is to patients.Reference Lewison and Devey ⁵¹ Diagnosing the “epidemiological susceptibility risk” of studies can uncover hidden biases across the evidence base. Such a process can also extend the scope of RoB assessment from within-study to between-study levels (note that between-study RoB is usually known as publication biasReference Yang, Sánchez-Tójar and O’Dea ⁵² while within-study RoB is just “risk of bias”). Studies are often not independent in terms of their conduct, with the same researchers potentially involved in multiple studies. Thus, highly represented authors (or research groups) may potentially dominate the production of evidence, limiting methodological diversity and generalizability. Indeed, centralized collaboration communities, which involve shared authors and employ similar protocols, have been shown to yield less replicable findings than decentralized ones, which incorporate more diverse independent research groups.Reference Danchev, Rzhetsky and Evans ⁵³ Moreover, the publication of false, exaggerated, and falsified effects is believed to be more common in countries with a “publish or perish” culture.Reference Fanelli ^{54 ,} Reference Anderson, Ronning, De Vries and Martinson ⁵⁵ For example, meta-scientific evidence suggests that studies from the United States tend to overestimate effect sizes and exhibit a larger publication bias.Reference Fanelli and Ioannidis ^{56 –} Reference Doucouliagos, Laroche and Stanley ⁵⁸

Bibliometrics can bring two major additions to meta-analyses. Bibliometrics can construct a co-authorship network for the studies included in a meta-analysis. Mapping the co-authorship network plot can intuitively reveal authorship dependence.Reference Moulin and Amaral ²⁹ Network metrics, such as the degree of centrality, can provide quantitative insights. Bibliometrics can also identify dominant and unrepresented countries of author affiliation, or reveal interdependences between countries. Following similar principles, bibliometrics can identify research location bias (e.g., studies from high-impact or predatory journals),Reference Jannot, Agoritsas, Gayet-Ageron and Perneger ^{59 ,} Reference Barker, Pollock and Stone ⁶⁰ funding source bias,Reference Barden, Derry, McQuay and Moore ^{61 ,} Reference Lynch, Cunningham, Warme, Schaad, Wolf and Leopold ⁶² linguistic bias,Reference Nuñez and Amano ^{63 ,} Reference Amano, Berdejo-Espinola and Akasaka ⁶⁴ and time-lag bias.Reference Koricheva and Kulinskaya ^{65 ,} Reference Yang, Lagisz and Nakagawa ⁶⁶ Notably, a quantitative assessment of those factors can be accomplished by conducting subgroup analysis or meta-regression.Reference Yang, Macleod, Pan, Lagisz and Nakagawa ⁴

4.2 Case studies

We use Data 3Reference Sanders, Frago, Kehoe, Patterson and Gaston ⁴³ to illustrate the application of bibliometric analysis in meta-analytic evidence base. We collected bibliographic data for the primary studies included in the meta-analysis from Scopus using digital object identifier) searches. We created two bibliographic network typologies using the associated data: co-authorship and country of affiliation. The co-authorship network was constructed through collaboration analysis by multiplying two matrices, Author × Paper and Paper × Author. For the country network, bibliographic coupling was used, involving multiplication of Paper × Cited paper and Cited paper × Paper. We used bibliometrix packageReference Aria and bibliometrix ²⁷ to construct network. Packages igraph Reference Csardi and Nepusz ⁶⁷ and circlize Reference Gu, Gu, Eils, Schlesner and Brors ⁶⁸ were used to project the networks.

4.3 Results and discussion

Figure 5 visually depicts the co-author network, with vertices (circles) representing authors and edges (lines) representing co-authorships in Data 3. Highly represented authors and dominant research groups can produce the majority of the evidence, reducing its methodological diversity and generalizability (certain groups might report certain results that are caused by bias in experimental designs and analyses).Reference Moulin and Amaral ²⁹

Figure 5

An example of a co-authorship network visualizing the diversity of the research groups and the degree of centralization of the scientific community. The vertices (nodes) and edges (links) denote authors and co-authorships, respectively. Bubbles of the same color represent the same author cluster or research team. Each color denotes a co-authorship cluster (or research group). The figure was inspired by Moulin et al.,Reference Moulin and Amaral ²⁹ who originally implemented it using Matlab and VOSviewer.

In the example meta-analytic data set, we observe nearly 90 author clusters, each of which, on average, included six authors. The largest cluster had 58 authors. To quantitatively detect the effect of hyper-dominant research groups on meta-analytic estimates, a leave-one-out analysis can be employedReference Yang, Macleod, Pan, Lagisz and Nakagawa ⁴ to compare the meta-analytic effect size estimates of each research group with that of the rest. Figure 6 shows the country of affiliation citation network with 34 countries of author affiliation. While there is no obvious indication of dominant countries (with country contributions shown as proportion of the circle’s perimeter), the United States, the United Kingdom, and Germany are the most prominent players in this field, and all countries appear to be linked well via article citations. At the statistical follow-up work, a multilevel meta-analytic model with random effects at the levels of author and country of affiliation clusters can be used to correct potential biases in country influence.Reference Yang, Macleod, Pan, Lagisz and Nakagawa ^{4 ,} Reference Moulin and Amaral ²⁹

Figure 6

An example of a chord diagram showing the epistemological interdependences between different countries of author affiliation in the meta-analytic evidence base. These inter-dependences are quantified using a bibliographic coupling approach. Two countries are coupled when the cumulative bibliographies of their respective papers share one or more cited references. The coupling strength, an indicator of dominance, increases as the number of co-cited references between them increases.

5.1 Rationale

Analysis of alternative impact metrics, termed “Altmetrics,” is an approach used to estimate research impact beyond academia.Reference Erdt, Nagarajan, Sin and Theng ³³ It can quantify societal impact by tracking activities on social media (e.g., Facebook and X [formerly Twitter]), Internet pages (e.g., Wikipedia), policy-related documents, and patent applications.Reference Erdt, Nagarajan, Sin and Theng ^{33 ,} Reference Bornmann, Haunschild and Adams ^{69 –} Reference Thelwall ⁷¹ Incorporating Altmetrics into a meta-analysis can reveal the uptake of research findings by stakeholders outside academia. For example, funding agencies have explored utilizing Altmetrics to assess public engagement with the research they support.Reference Dinsmore, Allen and Dolby ^{72 –} Reference Woolston ⁷⁴ Similarly, policymakers have used it to determine early engagement with research within the policy domain.Reference McCambridge, Hawkins and Holden ⁷⁵ We recommend visualizing the overall scores (e.g., Altmetric attention score), policy citations, patent citations, and overall social media attention received by studies within a meta-analysis to identify the extent to which these studies are translated into policy, practical applications, or general knowledge dissemination, respectively.

5.2 Case studies

We use one meta-analytic data to examine the replicability of the preclinical cancer biology.Reference Errington, Mathur and Soderberg ⁷⁶ to illustrate the application of Altmetrics analysis, based on data from Altmetrics online service (www.altemetric.com) (Data 4). All data and code necessary for reproducing the subsequent visualizations can be accessed at the https://yefeng0920.github.io/MA_Map_Bib/. The data used for this demonstration are derived from the work of Errington et al.,Reference Errington, Mathur and Soderberg ⁷⁶ who conducted a meta-analysis on the differences between the original effect size estimates and replicated effect size estimates across 50 cancer biology experiments. These experiments were sourced from 23 papers published in high-profile journals, such as Nature, Science, Cell, and PNAS.

We obtained Altmetric scores for each paper included in the meta-analytic dataset using the Altmetrics online service. This online service also provides data on the counts of policy documents and patent applications directly mentioned by organizational websites. We used API (application programming interface) to automatically retrieve the total Altmetric score, policy, and patent citation for each original publication. We visually represented the results using the orchard plotReference Nakagawa, Lagisz and O’Dea ⁷⁷ and grid-like graph.Reference Polanin, Zhang, Taylor, Williams, Joshi and Burr ¹⁸

5.3 Results and discussion

Figure 7a indicates the substantial social media attention earned by cancer biology studies included in the meta-analytic evidence base. Many of these studies were mentioned in policy documents and patent applications, indicating a potential degree of practical translation. Notably, fully replicated studies exhibited relatively higher Altmetric scores, and larger policy and patent citation counts compared to that of studies that were only partially replicated and not replicated. Among the fully replicated studies, those published in PNAS, Cancer Biology, and Cell, exhibited higher impact metrics than those published in Nature and Science.

Figure 7

Examples of visualization showing the results of impact metric analysis. (a) An orchard plot with Altmetric score as the bubble and impact metric related to indicators of practical application (i.e., patent and policy citation counts) as the bubble size. (b) A grid-like graph where: 1) the color and size of the bubbles correspond to the Altmetric score, and 2) the impact metric counts, related to the indicator of practical translation (i.e., patent and policy citation counts), respectively. The grey bubble indicates that the Altmetric score exceeds 400. The categories of “full,” “partial,” and “no replication” denote that replication of studies was as fully replicated, partially replicated, or not replicated, respectively.