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Existing studies on these associations have been considerably limited because of methodological flaws, which may account for controversial findings that have been reported.
However, the effect size of these clinical studies was underestimated because of methodological flaws, including inadequate statistical analysis, a failure to describe differences in baseline stroke severity, and an inadequate assessment period [ 11, 12].
Data available so far show that telemedicine solutions for diabetes care are feasible and acceptable, but their effectiveness in improving A1C, reducing costs while maintaining A1C levels, or improving other aspects of diabetes management is not fully clarified because of methodological flaws in study design (10, 11).
For example, recent studies 21 22 have argued that excluding studies because of methodological flaws or incomplete reporting may result in the loss of valuable new insights, whereas studies that are methodologically sound may suffer from poor interpretation of data, leading to an insufficient insight into the phenomenon under study.
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The latter review demonstrates a number of methodological flaws; hence, the findings must be extrapolated with caution.
"The appearance of such an effect in past research," wrote the authors, "appears to be the product of methodological flaws".
Importantly, the 12 studies rated as "inconsistent" had some signs of methodological flaws.
However, these studies have been criticized on the basis of methodological flaws and limited generalizability.
Overall, the evidence is Category 2, as studies were well designed but had a number of methodological flaws.
This study has a number of methodological flaws limiting generalisability, including absence of a control solution, and no blinding in acquisition of key study metrics (GCS).
There can be many reasons for these difficulties, some of which are the result of methodological flaws, for example genotyping errors.
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