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There were remarkable differences in trials' design (Table 1).
Because ROS production is very common and the human body has an abundant capacity for producing anti-oxidants, it is difficult to obtain statistical differences in trials designed to evaluate an anti-oxidative drug.
Therefore, mean differences in trials may conceal important effects in subgroups of patients [ 13].
Despite these therapies not being statistically significant relative to other treatments, they were retained in the model to control for unobserved differences in trials using newer treatment options compared with older treatments.
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We suggest that it is too early to draw strong conclusions because the two relevant trials cover different populations in different countries and there may be differences in trial conduct and outcome assessment.
The scientific implications of participant recruitment from these diverse geographic regions and of the differences in trial characteristics in different regions warrant further exploration.
There are several reasons for this variability, including differences between BCG substrains, exposure to non-tuberculous mycobacteria (NTMs), the nutritional or genetic background of the population, differences in trial methods and variations between different clinical Mycobacterium tuberculosis strains [ 2- 6].
Limitations to this meta-analysis include the subtle differences in trial design (open-label versus blinded) and the different GnRH analogues (leuprolide acetate and buserelin acetate) used in the two trials.
Differences in trial design, scheduling, and surgical interventions account for some of the variation in results.
This may reflect the pharmacologic heterogeneity of LMWH and/or differences in trial design.
However, differences in trial design and laboratory tests might have affected the outcome and might explain discordant results.
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