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While randomized studies of febuxostat with safety as the primary outcome would also be helpful, clinical trials often are of insufficient size, duration of follow-up, or have patients with insufficient generalizability to address such questions.
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The use of randomized clinical trials is limited in CER because of intrinsic weaknesses such as lack of generalizability, insufficient sample size, inadequate follow-up time, and high cost.
Thus, many of the early studies and their conclusions have been criticized for reasons such as low number of hormonal contraception users, poor comparability of different study groups, insufficient follow-up and poor generalizability of results (Morrison et al., 2005).
First, although the patients were enrolled at two general hospitals, their number (n = 146) might be insufficient to determine the reliability and generalizability of plasma NGAL.
Second, the quality of reporting of many validations was insufficient to assess the possibility of bias and generalizability of validity estimates across the GPRD.
There was also insufficient reporting on processes for dealing with missing data in many studies and this further restricted the studies' generalizability.
Insufficient emotion.
Insufficient community involvement?
That help proved insufficient.
Which was grossly insufficient.
That seems insufficient.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com