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The majority of studies were of low methodological quality with only little overlap in methodology and cytokines investigated.
The studies were all considered to have good methodological quality with a low risk of bias, but they were far from perfect.
The remaining 11 trials including 565 patients were of acceptable methodological quality with an average PEDro score of 6.9 (range 5 9).
The methodological quality assessment tool showed low to moderate methodological quality with variance of 38.46% to 69.23% of the total scores (Table 8).
Two independent reviews assessed methodological quality with the Jadad score.
The studies included are small in number and of variable methodological quality, with only one RCT.
Similar(29)
Inspection of the forest plots suggests that, in general, studies with a high risk of bias showed a more favourable diagnostic accuracy than those with more robust methodological quality, perhaps with the exception of cardiac procedures.
This is consistent with our findings that small studies had lower methodological quality compared with large trials.
The methodological quality assessments with the QUADAS-2 tool for the 18 included studies are summarized in Table 3 and Fig. 2.
Further research of better methodological quality and with more patient-relevant outcomes is needed".
It will be left to see how the methodological quality combines with other characteristics of the clinical recommendations.
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