21/n Not something that'll make headlines, perhaps, but sadly that's often how these things go
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22/n N.B. this study has already hit ~800 on Altmetric, been covered internationally, and made huge newspic.twitter.com/bj72yqShfA
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23/n Something else I didn't mention. Every study that I've looked at so far used a per-protocol analysis, which is a huge and worrying issue All of these should be at a high risk of attrition bias, yet none were rated as such. Most of them were green (low risk)pic.twitter.com/Y6sXlnkJHe
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24/n I've gotta say, for anyone teaching students about how finicky bias can be in systematic reviews, this is a beautiful example of getting it wrong
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25/n Somehow there are more issues here. This study was included in the risk of bias, but even though it assessed honey vs placebo/salbutamonl (and found no effect) it is not in any of the meta-analyses Very weirdpic.twitter.com/8AaMA85ERm
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26/n This is even weirder when you consider that the authors report excluding a study for not providing data So they exclude one study and report it, but another just...disappears? So strangepic.twitter.com/oyrp57yP1Y
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27/n Another included study using a per-protocol analysis. This was at least rated correctly as at a high risk of biaspic.twitter.com/t2mRMIq539
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28/n Another one. This study was rated at low risk of bias for most domains. Here's how they described their randomization and allocation concealment. What do you think?pic.twitter.com/1NM606xcRg
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29/n I'll give you a head-start - if they literally don't report ~how~ patients were randomized, by definition this should be unclear or high risk of bias for the domain of random sequence generation
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Replying to @GidMK
I'm not a native speaker, but to me "randomized alternatively" sounds as though all the even numbers went into one group and the odd numbers into the other. Could that be?
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Possible. The language leaves it open to interpretation
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