Exact(4)
Sensitivity analyses were performed excluding poor quality trials.
Poor quality trials were more likely to suggest treatment benefits in experimental groups.
However, meta-analysis is limited by inclusion of poor quality trials that are prone to report biased findings and exclusion of unpublished trials that do not report findings.
This will allow the identification of poor quality trials in a less arbitrary way than the Wampold et al. (1997) criteria.
Similar(56)
When the two poorest quality trials, and therefore the greatest source of bias, are removed from the meta-analysis, the result is not statistically significant.
Some asymmetry may also have been caused by the tendency in this review for the poorer quality trials to show larger effects, as documented elsewhere.
There was however, a contrast in the results obtained from the four better quality trials, scoring three or above, when meta-analyzed separately from the two poorer quality trials.
7 Poor-quality trials and risk of publication bias will reduce the strength of evidence when developing clinical practice guidelines or preparing systematic reviews.
Poor-quality trials can introduce bias and multiple statistical testing as new trials accumulate may increase the risk of false-positive results.
There was weak evidence from three poor-quality trials of a large positive effect of psychoeducation on social functioning (SMD = 1.15, 95% CI 0.06 2.25, P≤0.001, I = 95%, n = 362).
▪ A score between -0.5 and +0.5 indicates a lack of evidence of efficacy because it is obtained in case of conflicting evidence or when a majority of poor-quality trials are available.
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