As a result of these constraints, many of the basic principles of impact evaluation design (comparable pretest posttest design, control group, instrument development and testing, random sample selection, control for researcher bias, thorough documentation of the evaluation methodology, etc).
Although this approach reduced the information bias during documentation, incomplete charting could lead to gaps in knowledge.
Some of these are inherent to retrospective reviews and others specific to the human bias in documentation and data collection.
However, efforts should be made to improve abstract reporting, handling of heterogeneity, assessment of publication bias, and documentation of reviewer's agreement and trials flow.
Patient record audits offer several advantages, including detailed information and longitudinal data about symptoms, investigations and diagnosis evolution, but their limitations include the potential for hindsight bias, missing documentation and review time (Zwaan et al, 2010).
However, design documentation seems to be biased toward technical aspects of the chosen solution, while information about the context of the design process is typically not available.
Therefore the findings of this landscape analysis may be biased towards companies that had more documentation.
Misclassification of documentation quality measures could have biased the results toward the null, and a true relationship between some of the physician or patient variables and documentation quality may not have been detected by this study.
Furthermore, the documentation of symptoms may have been biased by the underlying diagnosis.
Information provided by GPs may have been biased as the GP had knowledge of the suicide attempt at the time of documentation [ 29].
