Our results are also in good agreement with a previous report showing that the probability of obtaining surrogate consent was higher for low-risk and moderate-risk studies than for high-risk studies [ 10].
For the report of parental concerns on the PEDS indicating moderate developmental risk, studies done in high income countries reported a significantly higher rate than those done in low and middle income countries.
None of the study qualities were significantly associated with the effect measure (OR) in the meta-regression (p=0.086), and the pooled estimate from those with a moderate risk of study bias was much higher than that of studies with high or low risk of bias.
According to the quality criteria listed above, we considered all included studies were at moderate risk of bias and graded as category B 7 studies demonstrated the complete response rate of locally-used interferon (intralesional interferon or gel interferon) as compared to placebo for treating genital warts.
Based on the quality criteria described in the methods section, two studies were classified as having a low risk of bias [ 32, 38], 12 studies as having moderate risk of bias [ 33, 36, 37, 39- 45, 45, 48- 55], and seven studies were classified as having a high risk of bias [ 34, 35, 43, 44, 46, 47, 56].
We found 6 studies to have a high risk of bias [25 28, 32, 33], three studies to have a moderate risk of bias [29, 31, 34, 35], and no studies to have a low risk of bias.
VMS studies at moderate risk of bias showed rapid and sustained increases in SDC.
The small number of studies and moderate risk of bias impacts on the interpretation and strength of the evidence.
Most of our collected studies have moderate risk of bias based on the assessment of the Jadad Scale.
This was not significant due to the small number of studies with moderate risk of bias (see online supplementary data).
