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This study alone identified almost six million people, and even this underestimates the problems because the study excluded patients with a cancer diagnosis or who were in hospice.
Within the patient selection domain, studies were considered to be at high risk of bias if a case control study design was used, or because the study excluded certain groups of patients.
Because the study excluded participants who did not complete the training or completed only the baseline session, dropout is only evidenced in the 3- and 6-month follow-up assessments.
A recent population-based survey in Japan reported a prevalence of 1 in 2.7 million, but this value may be low because the study excluded severely affected infants who died at very young ages and adult-onset patients are often missed (Yoshida et al., 2011).
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On the other hand, the sample size was based on a pilot study and the post hoc power was very high because of the specific design of the study, excluding the abovementioned confounding variables [30, 50].
A flowchart describing the screening processes is shown in Fig. 1.> -wrap-foot> These are the studies excluded where because of lack of clarity it was necessary to discuss their inclusion in the review at a regular research meeting Three included studies were from USA [ 37, 39, 40], two from Belgium [ 41, 42], one from Canada [ 36] and one from the UK [ 38].
The sample for the longitudinal study is smaller than the original Warfighter Status Survey sample (N = 1576), because the longitudinal study excluded Marines who had a previous psychiatric diagnosis on record at the time of survey completion, and also excluded Marines for whom follow-up medical or deployment data could not be obtained.
Second, because our study excluded patients with cardiac arrhythmias, we do not know its applicability in this setting.
Those assumed to be most at risk of HPV infection were underrepresented in our sample because of the lower response rate from those from areas of high social deprivation, in which indicators of sexual health are known to be poorer (Scottish Executive, 2006), and also because the study design excluded those 11- to 18-year olds who were no longer in education and training.
Besides genetic differences and life style factors, a selection bias might lead to lower prevalence of osteoporosis because the eligibility criteria in this study excluded all subjects who were not healthy.
Firstly, potential publication biases may exist in this meta-analysis because studies excluded the non-English-language publications.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com