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Previous studies that have addressed this relationship have had mixed results and serious methodological flaws associated with study design are common.
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Some of the specific methodological flaws are associated with lack of adequate reporting of randomization, inadequate sample sizes to detect real differences in outcomes, high attrition rates and lack of blinding in assessments [ 24].
In meta-epidemiological research, researchers often assume that bias (from methodological flaws) in clinical trials is associated with an exaggerated effect of treatment.
Available evidence is scarce and frequently associated with major methodological flaws and confirmation bias.
A larger and more comprehensive review [ 1] of 26 studies found no evidence that baseline eating disorder symptom severity, psychiatric co-morbidity or treatment issues affected dropout and concluded that factors associated with dropout were inconsistent due to methodological flaws and small sample sizes.
Reduced HMI time to RTP was reportedly associated with Actovegin injections in professional footballers 139 though methodological flaws compromise the interpretation of outcomes of this pilot study.
We could not further determine associations of treatment effects with potential biases derived from methodological flaws.
Song et al highlighted the methodological flaws in published indirect comparisons and made recommendations regarding suitable methodology.
17 18 19 20 For hip fracture surgery, two meta-analyses of 15 and 22 randomized clinical trials comparing regional with general anesthesia found borderline significant results of a reduced short term risk of mortality associated with regional anesthesia, but no evidence of a decreased risk at three months post-surgery or beyond 10 21; all included studies had important methodological flaws.
All had serious methodological flaws.
Previous studies had methodological flaws, and their results were contradictory.
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