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Some of the included studies keep low-quality because many trials have design limitations.
Evaluations of strategies that encourage participants to return to sites for follow-up visits and monitoring are particularly needed because many trials collect outcome data in this way.
However, definite conclusions on the efficacy of secondary prophylaxis cannot be drawn from these observations because many trials report a decline in the incidence of FN in later cycles without administering prophylaxis (Hupperets and Tjan-Heijnen, 2006).
Although pooling results for patient subgroups from trials in this way might introduce bias and the meta-analysis is again limited because many trials tested only a relatively small subset of patients for mutation status, or did not test at all, they do provide the best available estimate of the effects of TKIs in patients with wild type and mutated EGFR.
This gap exists because many trials are registered retrospectively (24.9% of all trials registered in 2013 reported a date of first enrolment in 2012 or in an earlier year; 12.2% in 2012, 5.2% in 2011, 2.8% in 2010, 1.7% in 2009, 1% in 2008 and 2% in 2007 or earlier).
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But many trials are delayed because not enough people enroll.
Moreover, because gambling paradigms involve many trials, they make it almost inevitable that any regret effects will be due to anticipated rather than experienced regret.
Many trials fail because of unrealistic recruitment targets and flawed recruitment strategies.
This is partly because of methodological limitations in many trials of acupuncture, including small sample sizes, lack of credible sham-controls, and inadequate blinding [ 40].
I was able to survive my many trials and tribulations because of my belief in Wakan Tanka (God).
On the other hand, according to Cochrane and other independent reviews, many clinical trials on TCM were inconclusive, at least partially because of the low quality of many trials conducted in China [ 62].
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