Exact(5)
Caution should be exercised because the available evidence largely originates from heterogeneous studies with weak designs, conducted in experimental settings with nonclinical participants (i.e., medical students).
Studies with weak methodological rigor were assigned an evidence level of 2b.
The literature on feeding people with dementia has been systematically reviewed, finding that there are few studies, with weak methodology and small sample sizes to inform interventions to improve feeding for those with dementia[ 46].
Our feature selection experiments indicate that experimental inputs complementary to ChIP-seq are critical in identifying biological significant signals from ChIP studies with weak signals due to indirect DNA binding.
Funnel plots indicated that there was under-representation of small studies with weak or absent association, both for all studies combined, as well as for the studies in the high-exposure category (figure 2).
Similar(55)
And, the work noted, the studies that indicated a benefit from some coping strategies tended to be smaller studies with weaker designs.
Although the RCT is the best study design to provide evidence on effectiveness, the results from studies with weaker designs may inform the planning of future RCTs45, of which both are valuable from research and clinical practice perspectives.
For studies with weaker efficacy data, further efficacy studies are needed.
The visual inspection of the funnel plot suggests the existence of publication bias, with smaller studies with weaker associations being underrepresented, although it is not statistically significant according to Egger's regression asymmetry test (P=0.596).
There is some evidence that more comprehensive search strategies have little effect on the overall result of systematic reviews and may introduce bias by including studies with weaker designs (Egger et al, 2003).
The lower rates of constipation in the tramadol and 'other opioid' (three of the four studies were with weak opioids) studies are probably a result of the relatively weak µ-receptor binding in the gut of these weak opioids compared with morphine.
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