21 For studies that did not present mean differences and confidence intervals, these estimates were calculated using the confidence selleck compound interval calculator downloaded from the PEDro website. Due to the clinical heterogeneity of the studies included in this
systematic review and the variability between health conditions assessed, a meta-analysis was not possible. Therefore, the data analysis was descriptive. For the primary outcomes of pain intensity and disability, descriptive forest plots without pooling were performed for better visualisation. In all cases of multiple follow up points, only the longest-term measurement point available was plotted. Disability scales were converted to a common 0–100 scale. Forest plots were performed only for comparisons with two or more studies. RevMan 5.1 was used for the analysis. The overall
quality of the evidence and the strength of recommendations were evaluated using the GRADE approach.22 The GRADE approach specifies four levels of quality (high, moderate, low and very low). The overall evidence was downgraded depending on the presence of five factors: Panobinostat cell line limitations (due to risk of bias); consistency of results; directness (eg, whether participants are similar to those about whom conclusions are drawn); precision (ie, sufficient data to produce narrow confidence intervals); and other (eg, publication bias). The quality of evidence was then classified for each outcome according to the following criteria: There are consistent findings among many at least 75% of the participants from low risk of bias studies; consistent, direct and precise data; and no known or suspected publication biases. Further research is unlikely to change either the estimate or confidence in the results. One of the domains is not met. Further research is likely to have an important impact on confidence in the estimate of effect
and may change the estimate. Two of the domains are not met. Further research is very likely to have an important impact on confidence in the estimate of effect and is likely to change the estimate. Three of the domains are not met and the results are very uncertain. No randomised trials were identified that addressed this outcome. Single studies with a sample size smaller than the optimal information size (n = 300) were considered to yield very low-quality evidence if there was also a high risk of bias (PEDro score < 6) or low-quality evidence if there was a low risk of bias (PEDro score ≥ 6). From the search strategy, 275 potentially relevant studies were retrieved. Of these, 12 studies were considered eligible for data analysis.3, 4, 5, 11, 12, 13, 14, 23, 24, 25, 26 and 27 The flow of studies through the selection process is presented in Figure 1. The 12 eligible trials were published between 2008 and 2013. The sample sizes ranged from 10 to 76 participants12 and 13.