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However, most clinical studies of the association of placental features with adverse neurologic or psychiatric outcome have substantial methodologic limitations.
Despite the substantial methodologic differences and sources of uncertainty that differentiate PMF from CMB-LGO, the epidemiologic model results were strikingly similar in direction and magnitude.
The substantial methodologic difficulties existing in this area were outlined and guidelines were laid out, fueled in part by recent collaborations such as Interlymph and the NCI Cohort Breast and Prostate Cancer Consortium, on how to design, conduct, and analyze data from large, collaborative efforts.
In addition, several studies have had substantial methodologic inadequacies for instance, one study that found apparently increased risks for many different cancers used more sources of exposure information for cancer cases than for noncancer subjects and was analyzed improperly (Szmigielski et al. 2001).
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"All the studies pointing to them being associated with brain tumors have significant methodologic flaws".
However, they also have significant methodologic challenges.
Because of substantial heterogeneity and methodologic limitations of the original studies, we considered that quantitative pooling was inappropriate.
Because of substantial heterogeneity and methodologic limitations, we present a qualitative systematic review, and we used only meta-analysis techniques for studies from Taiwan and Bangladesh.
Although several earlier studies failed to detect this substantial impact, they may have been subject to methodologic limitations not present in the Mexico City investigation (Hertz-Picciotto 2000).
Because of a substantial heterogeneity in the included studies regarding the methodologic quality, the MRI findings, the MRI technique used, and the regions under evaluation, it was not possible to perform a meta-analysis, and we decided not to report data systematically.
The substantial heterogeneity between studies could be due to differences in methodologic quality, study design, sampling variability, and study populations across studies.
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