Caution is needed when describing a study design as meta-epidemiological

Puljak, Livia

doi:10.1016/j.jclinepi.2022.10.017

Cited by 3 publications

(1 citation statement)

References 19 publications

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“…Our study included only published reports, meaning that there is a risk that we have failed to incorporate unpublished studies. We did not consider whether the studies adhered to the actual definition of meta-epidemiological studies as described by Moustgaard et al 16 , 42 As highlighted by the literature, the definition of meta-epidemiological studies is unclear, and researchers used it inconsistently. Secondly, meta-epidemiological studies did not assess the risk of bias; therefore, they included RCTs of any methodological quality, indirectly creating bias across the included meta-epidemiological studies.…”

Section: Discussionmentioning

confidence: 99%

The influence of bias in randomized controlled trials on rehabilitation intervention effect estimates: what we have learned from meta-epidemiological studies

ARIENTI,

ARMIJO-OLIVO,

FERRIERO

et al. 2023

Eur J Phys Rehabil Med

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This study aimed to synthesize evidence from studies that addressed the influence of bias domains in randomized controlled trials on rehabilitation intervention effect estimates and discuss how these findings can maximize the trustworthiness of an RCT in rehabilitation. We screened studies about the influence of bias on rehabilitation intervention effect estimates published until June 2023. The characteristics and results of the included studies were categorized based on methodological characteristics and summarized narratively. We included seven studies with data on 227,806 RCT participants. Our findings showed that rehabilitation intervention effect estimates are likely exaggerated in trials with inadequate/unclear sequence generation and allocation concealment when using continuous outcomes. The influence of blinding was inconsistent and different from the rest of medical science, as meta-epidemiological studies showed overestimation, underestimation, or neutral associations for different types of blinding on rehabilitation treatment effect estimates. Still, it showed a more consistent pattern when looking at patient-reported outcomes. The impact of attrition bias and intention to treat has been analyzed only in two studies with inconsistent results. The risk of reporting bias seems to be associated with overestimation of treatment effects. Bias domains can influence rehabilitation treatment effects in different directions. The evidence is mixed and inconclusive due to the poor methodological quality of RCTs and the limited number and quality of studies looking at the influence of bias and treatment effects in rehabilitation. Further studies about the influence of bias in RCTs on rehabilitation intervention effect estimates are needed.

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Section: Discussionmentioning

confidence: 99%