On the construction and interpretation of the Doi plot in prevalence meta-analyses

The Doi plot and the Luis Furuya-Kanamori (LFK) index are increasingly used tools for assessing small-study effects and potential publication bias in meta-analysis. Their validity, however, depends critically on correct graphical construction and interpretation. This methodological communication clarifies the conceptual basis of the Doi plot, with particular emphasis on its application in meta-analyses of prevalence, where transformations of proportions introduce additional considerations. We revisit the definition of the plot axes-effect size versus absolute Z-score (|Z|)-and explain how |Z| relates to study precision under commonly used transformations. Using a recently published anatomical meta-analysis as an illustrative example, we demonstrate how the Doi plot and LFK index can be reconstructed and interpreted in prevalence meta-analysis. Practical recommendations for the implementation and reporting of Doi plot analyses are provided to enhance transparency, reproducibility, and methodological rigor in anatomical and biomedical research.