So there would be a significant investment but low-quality outcome.
However, since the majority of the included studies were case reports/series, which were also judged with rather low quality, the outcomes of the respective studies should be interpreted with caution and probably cannot be generalized to the average patient with similar dental malocclusions.
A poorly conducted PDP can lead to low quality project outcomes, dissatisfaction among users, delays and higher costs [ 11, 23].
However, given the risk of bias in the included studies, and the very low quality of outcomes, the magnitude of the effects is uncertain.
The evidence for the comparison of one intervention versus none was generally high to moderate, with low quality for one outcome (pregnancy-related deaths) in which many of the studies contributing to the data had design limitations.
Findings from this review must be interpreted with caution as studies were typically of low quality and most outcomes were based on a small number of studies.
Findings from this review must be interpreted with caution as studies were generally of low quality and most outcomes were based on a small number of studies.
This different methodology explains the discrepancy between the statement of Mais et al. [44] that all the included trials in their systematic review were judged to be of a high quality which contrasts with our judgment of "very low quality evidence" for the outcomes of pregnancy and incidence of de novo adhesions.
Combined effects for positive symptoms of psychosis (fig 4), depression, and quality of life were not significant at any time point, but there was only low quality evidence for all outcomes except for positive symptoms within six and 12 months.
These findings should be interpreted in the light of several limitations, including the lack of blinding, outcome reporting bias, heterogeneity, and the consequent very low quality of evidence for all outcomes.
Our application of GRADE methodology led us to conclude that the accumulated evidence is of low quality for mortality and neurological outcome.
