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While individual trial study could fail to show a statistically significant treatment effect, systematic reviews and meta-analysis of combined results might reveal the potential benefits of treatment.
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The authors also caution that the quality of the individual trials studied for the new review varied greatly.
To investigate the risk of possible bias by individual clinical trial studies, we undertook a sensitivity analysis.
Thus, some questions may have been addressed by individual trials or study designs that were not included in a systematic review.
To investigate the risk of possible bias in individual clinical trial studies, we relied on standardized reporting methods of clinical trial results as outlined by WHO and RECIST response rate criteria introduced in 2000.
This is especially true since a meta-analysis may present the only feasible method to estimate potential risks, due to the often infrequent occurrence of adverse events within an individual trial or observational study.
Two of the authors independently reviewed the studies included in the meta-analysis to appraise the quality of the individual trial using criteria developed for Study Protocol and Data Analysis and Presentation by Chalmers et al. [ 39] and the method of Jadad et al. [ 40].
However, a definitive assessment of this risk would require analysis of the individual trial data from the angina studies and possibly even a prospective study of angina patients similar in size to the SHIFT and BEAUTIFUL studies.
The trials had comparable study populations; individual trial inclusion criteria consisted of patients with indications for screening or diagnostic colonoscopy.
The unit of analysis was the individual study and not the individual trial participant.
We reviewed 318 full texts, from which 58 manuscripts describing 24 individual trials (18 new studies) [ 126– 183] were eligible for the systematic review.
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