Journal of clinical epidemiology
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Meta-analyses of randomized controlled trials (RCTs) provide the highest level of evidence regarding the effectiveness of interventions. Less is known about how they are used to inform the design and reporting of RCTs. ⋯ Consulting previous research before embarking on a new trial and basing decisions about future research on the impact on an updated meta-analysis will make the reporting of research more coherent and the design of new RCTs more efficient.
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Statisticians have criticized the use of significance testing to compare the distribution of baseline covariates between treatment groups in randomized controlled trials (RCTs). Furthermore, some have advocated for the use of regression adjustment to estimate the effect of treatment after adjusting for potential imbalances in prognostically important baseline covariates between treatment groups. ⋯ Our findings suggest the need for greater editorial consistency across journals in the reporting of RCTs. Furthermore, there is a need for greater debate about the relative merits of unadjusted vs. adjusted estimates of treatment effect.
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Randomized controlled trials (RCTs) are considered the highest grade of research evidence, yet properly conducted trials investigating the same association often yield conflicting results. Our objective was to assess whether variability in treatment protocols of RCTs investigating the same topic could explain distinct patterns of outcomes. ⋯ Conflicting results from RCTs can represent a spectrum of "real" outcomes for specific treatments. Such trials are best evaluated by considering concurrently both the validity of study design as well as the generalizability of patients and interventions involved.
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Mistriage can have serious consequences for patients with urgent complaints. We therefore reviewed the assessment of triage-reliability, and propose an alternative weighted kappa that accounts for severity of mistriage. ⋯ No existing studies on reliability of triage systems account for mistriage. Using triage-weighted kappa, which reflects severity of mistriage, shows that the reliability of triage systems is lower than reported.
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To describe the quality and methods of systematic reviews of physiotherapy interventions, compare Cochrane and non-Cochrane reviews, and establish the interrater reliability of the Overview Quality Assessment Questionnaire (OQAQ) quality assessment tool. ⋯ The quality of systematic reviews in physiotherapy is improving, and the use of Cochrane Collaboration procedures appears to improve the methods and quality.