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One study with unclear method of diagnosis [ 45] found limited evidence for effects on positive and negative symptoms when comparing yoga to usual care.
Nifedipine was administered by capsule puncture/biting (n = 4), swallowing of capsule whole (n = 1), or by an unclear method (n = 3).
Other potential sources of bias in this RCT were unclear method of randomisation, inadequate (or unclear) allocation concealment and blinding of assessors, and a 31% loss to follow-up.
Randomisation: adequate (methods such as computer generated random numbers or use of a random number table), inadequate (methods such as assignment based on day of presentation or alternation), unclear (method not described).
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Where abstracts were unclear, methods sections were reviewed.
In general, reports on multiple injuries after this earthquake have been anecdotal [ 16, 19], or used unclear methods [ 19].
Of the third of studies that were randomized trials, most were open label with unclear methods of randomization and allocation concealment.
Most studies had low risk of bias, though assessment of bias was difficult because of unclear methods in two studies 18 23 (appendix 3).
Citations that did not meet the inclusion criteria, were irrelevant for the aim of the study, or had unclear methods were excluded (n = 1123), as were duplicates (n = 23).
Risk of bias was unclear in 13 trials, largely due to missing ICCs and unclear methods of adjusting for clustering (Basinga 2011; Darmstadt 2010; Fottrell 2013; Klerman 2001; Laken 1995; le Roux 2013; Manandhar 2004; Midhet 2010; Tripathy 2010; Villar 1992; Wahlstrom 2011; Walker 2013; Wu 2011), and high in one trial, where results were not reported according to the randomisation group (Omer 2008).
In most clinical trials performed in this area, often burdened by severe methodologic limitations including excessive clinical heterogeneity, investigators use different definitions of SE (and its stages), adopt inappropriate comparators, or use unclear methods of data presentation [ 35– 37], so that reaching definite evidence is an extremely challenging task.
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