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A challenge in assessing non-drug treatments is related to difficulties of blinding.
Due to the difficulties of blinding in acupuncture research generally, Birch [ 10] has highlighted the added importance of ensuring that all stages of analysis are blinded, from data-entry to evaluation of the results.
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This reflects the difficulty of blinding participants in these trials.
The risk of bias of the RCTs is low if the difficulty of blinding is considered.
Although the optimal definition of VAP is controversial [ 41], the lack of standardized definition and the difficulty of blinding render the results susceptible to ascertainment bias.
When using methodology assessment tools such as the Risk of Bias instrument, the difficulty of blinding creates a disadvantage for manual therapy studies compared to studies using other interventions like pharmaceuticals which can easily be blinded.
35 37 Although perceptions of fatigue is an important variable for athletes, limitations do exist using this measure in studies due to difficulty of blinding participants to whether they have received treatment (compressive clothing) versus passive recovery.
Because of the frequency of non-serious adverse events associated with methylphenidate, the particular difficulties for blinding of participants and outcome assessors point to the advantage of large, "nocebo tablet" controlled trials.
Mr. Heinecke was awakened to the difficulties of the blind and to the subtle denigration and fear that often greeted them.
Given the difficulties in blinding the acupuncturist, we only assessed the blinding of participants and outcome assessors.
One person deemed it a "very serious leg injury". Another brought up the difficulty of a blind landing.
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