There are also potential medical risks to patients associated with poor quality online information, self-diagnosis and self-treatment, passive monitoring, and the use of unvalidated smartphone apps.
There is also potential for medical harm related to poor quality online information, self-diagnosis and self-treatment, passive monitoring, and the use of unvalidated smartphone apps.
This wide variation in outcome methodology is hindering evidence-based practice, and the widespread use of unvalidated outcome measures is a potential source of bias and inaccuracy.
Overall Quality Index score was only 7.1 out of 14, indicating significant design limitations of many included studies, including highly selective sampling methods and the use of unvalidated outcome measures.
Prior studies evaluating predictors of pain-related outcomes following treatment for sciatica have been limited by methodological problems, including retrospective study design, use of unvalidated outcome measures, and short-term follow-up periods.
Criticisms of the RIO trials included the use of unvalidated or disputed surrogate endpoints [24], [25], favorable claims not supported by trial data [26], overstated treatment efficacy [27], downplayed adverse effects [25], [28], [29], lack of internal validity and external validity or generalizability [30], [31], and failure to disclose financially-conflicted interests [32].
A further limitation was the lack of reporting of or use of unvalidated outcome measures.
Other limitations of the review arise from the heterogeneity of study populations, measures and outcome variables, as well as the frequent use of unvalidated measures of knowledge.
Some methodological limitations with these more recent studies remain, including the lack of randomized trials, use of unvalidated measuring instruments and lack of control of extraneous variables [ 14].
