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There were only four studies dealing with SQCC and it was a nonsense to make more reduced subgroups analysis.
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Urinary C-terminal cross-linking telopeptides of type I collagen in the EOA subgroup is more significantly reduced (P = 0.017) at t2 with GCC compared to GC (Fig. 4).
However, reducing the vast individual differences present in early childhood development into broad dichotomous categories may be problematic, as valuable detail becomes lost, particularly if the sample size is substantially reduced by selecting more extreme subgroups only [ 84, 93].
Heterogeneity between studies was partly reduced in subgroup analyses.
However, heterogeneity was also reduced by subgroup analyses.
Since the subgroup analysis showed that HbA1c tended to be reduced more in participants with higher HbA1c levels at baseline, the smaller reduction in HbA1c in the present study might be associated with the lower HbA1c baseline level.
Clinical heterogeneity of participants in clinical trials is hypothesised as reducing the likelihood of demonstrating treatment effects, and sampling of more homogenous subgroups is recommended.
On the other hand, the findings of this study might have been even more compelling if an even more vulnerable subgroup of patients (for example, reduced performance state, severe symptoms) had been evaluated.
Wolffsohn et al. found that patients who were assisted by someone reported higher disability levels measured with the LVQOL; they concluded that the subgroup which was assisted with administration had more vision loss and reduced contrast sensitivity than the self-report subgroup, but also suggested that the difference might reflect a negative bias introduced by the patient's relative [ 40].
Therefore, an 'overly-sensitive' subgroup structure can be reduced by collapsing 'daughter' subgroups.
Signals towards a reduced risk in subgroup analyses deserve further study.
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Justyna Jupowicz-Kozak
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