Table 2.
Downs and Black Quality Index results for each study
| 1. Clear aim/ hypothesis | 2. Outcome measures described | 3.Patient characteristics described | 4. Intervention clearly described | 5. Principal confounders | 6. Findings clearly described | 7. Random variability | 8. Adverse events | 9. Lost to follow-up | 10. Probability values reported | 11. Asked subjects representative | 12. Inc. subjects representative | 13. Staff & facilities representative | 14. Attempt blinding participants | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Allen et al. [22] | 1 | 1 | 1 | 1 | 2 | 1 | 1 | 0 | 1 | 1 | U | U | 1 | 1 |
| Willy et al. [40] | 1 | 1 | 1 | 1 | 2 | 1 | 1 | 0 | 1 | 1 | U | U | 0 | 1 |
| Baumgartner et al. [27] | 1 | 1 | 1 | 1 | 2 | 1 | 1 | 0 | 1 | 1 | U | U | 1 | 0 |
| Bowerstock et al. [30] | 1 | 1 | 1 | 1 | 2 | 1 | 1 | 0 | 1 | 1 | U | U | 0 | 0 |
| Gerrard and Bonanno [35] | 1 | 1 | 1 | 1 | 2 | 1 | 1 | 0 | 1 | 1 | U | U | 0 | 1 |
| Bonacci et al. [29] | 1 | 1 | 1 | 1 | 2 | 1 | 1 | 0 | 1 | 1 | U | U | 0 | 0 |
| Bonacci et al. [28] | 1 | 1 | 1 | 1 | 2 | 1 | 1 | 0 | 1 | 1 | U | U | 0 | 0 |
| Busa et al. [31] | 1 | 1 | 1 | 1 | 2 | 1 | 1 | 0 | 1 | 1 | U | U | 0 | 0 |
| Chumanov et al. [32] | 1 | 1 | 1 | 1 | 2 | 1 | 1 | 0 | 1 | 1 | U | U | 0 | 0 |
| dos Santos et al. [34] | 1 | 1 | 1 | 1 | 2 | 1 | 1 | 0 | 1 | 1 | U | U | 0 | 0 |
| dos Santos et al. [33] | 1 | 1 | 1 | 1 | 2 | 1 | 1 | 0 | 1 | 1 | U | U | 0 | 0 |
| Hunter and Smith [42] | 1 | 1 | 1 | 1 | 2 | 1 | 1 | 0 | 1 | 1 | U | U | 0 | 0 |
| Lenhart et al. [36] | 1 | 1 | 1 | 1 | 2 | 1 | 1 | 0 | 1 | 1 | U | U | 0 | 0 |
| Lieberman et al. [37] | 1 | 1 | 1 | 1 | 2 | 1 | 1 | 0 | 1 | 1 | U | U | 0 | 0 |
| Wang et al. [38] | 1 | 1 | 1 | 1 | 2 | 1 | 1 | 0 | 1 | 1 | U | U | 0 | 0 |
| Wellenkotter et al. [39] | 1 | 1 | 1 | 1 | 2 | 1 | 1 | 0 | 1 | 1 | U | U | 0 | 0 |
| Yong et al. [41] | 1 | 1 | 1 | 1 | 2 | 1 | 1 | 0 | 1 | 1 | U | U | 0 | 0 |
| Baggaley et al. [44] | 1 | 1 | 1 | 1 | 2 | 1 | 1 | 0 | 1 | 1 | U | U | 0 | 0 |
| Hafer et al. [47] | 1 | 1 | 1 | 1 | 2 | 1 | 1 | 0 | 1 | 1 | U | U | 0 | 0 |
| Heiderscheit et al. [49] | 1 | 1 | 1 | 1 | 2 | 1 | 1 | 0 | 1 | 0 | U | U | 0 | 0 |
| Huang et al. [50] | 1 | 1 | 1 | 1 | 2 | 1 | 1 | 0 | 1 | 0 | U | U | 0 | 0 |
| Lenhart 2014 et al. [51] | 1 | 1 | 1 | 1 | 2 | 1 | 1 | 0 | 1 | 0 | U | U | 0 | 0 |
| Lenhart et al. [52] | 1 | 1 | 1 | 1 | 2 | 1 | 1 | 0 | 1 | 0 | U | U | 0 | 0 |
| Neal et al. [55] | 1 | 1 | 1 | 1 | 2 | 1 | 1 | 0 | 1 | 1 | U | U | 0 | 0 |
| Swinnen et al. [26] | 1 | 1 | 1 | 1 | 2 | 0 | 1 | 0 | 1 | 1 | U | U | 0 | 0 |
| Zimmerman et al. [57] | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 0 | 1 | 0 | 1 | U | 0 | 0 |
| Adams et al. [43] | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 0 | 1 | 1 | U | U | 0 | 0 |
| Bramah et al. [23] | 1 | 1 | 1 | 1 | 2 | 1 | 1 | 0 | 1 | 0 | U | U | 0 | 0 |
| Garofolini et al. [58] | 1 | 1 | 1 | 1 | 2 | 1 | 0 | 0 | 1 | 1 | U | U | 0 | 0 |
| Halvorsen et al. [48] | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 0 | 1 | 1 | U | U | 0 | 0 |
| Hobara et al. [25] | 1 | 1 | 1 | 1 | 2 | 0 | 1 | 0 | 1 | 0 | U | U | 0 | 0 |
| Mercer et al. [53] | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 0 | 1 | 1 | U | U | 0 | 0 |
| Morin et al. [54] | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 0 | 1 | 0 | U | U | 0 | 0 |
| Quinn et al. [56] | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 0 | 1 | 1 | U | U | 0 | 0 |
| Clarke et al. [45] | 1 | 1 | 0 | 1 | 1 | 1 | 1 | 0 | 1 | 0 | U | U | 0 | 0 |
| Connick and Li [46] | 1 | 1 | 1 | 1 | 1 | 1 | 0 | 0 | 1 | 0 | U | U | 0 | 0 |
| Dewolf and De Jaeger [24] | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 0 | 1 | 0 | U | U | 0 | 0 |
| 15. Attempt blinding clinicians | 16. Data dredging | 17. Analysis adjust for follow-up | 18. Statistics appropriate | 19. Compliance with intervention | 20. Outcome measures accurate | 21. Recruited same population | 22. Recruited over same period | 23. Randomised to groups | 24. Randomisation concealed | 25. Adjustment for confounding | 26. Accounted for lost to follow-up | 27. Power to detect clinical effect | Total (score out of 28) |
|
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Allen et al. [22] | 0 | 1 | 1 | 1 | 1 | 0 | U | 1 | 1 | 1 | 1 | 1 | 1 | 22 |
| Willy et al. [40] | U | 1 | 1 | 1 | 1 | 1 | U | 1 | 1 | 1 | 1 | 1 | 1 | 22 |
| Baumgartner et al. [27] | 0 | 1 | 1 | 1 | 1 | 1 | U | 1 | 1 | U | 1 | 1 | 1 | 21 |
| Bowerstock et al. [30] | 0 | 1 | 1 | 1 | 1 | 1 | U | 1 | 1 | 1 | 1 | 1 | 1 | 21 |
| Gerrard and Bonanno [35] | 0 | 1 | 1 | 1 | 1 | 1 | U | 1 | 1 | U | 1 | 1 | 1 | 21 |
| Bonacci et al. [29] | 0 | 1 | 1 | 1 | 1 | 1 | U | 1 | 1 | U | 1 | 1 | 1 | 20 |
| Bonacci et al. [28] | 0 | 1 | 1 | 1 | 1 | 1 | U | 1 | 1 | U | 1 | 1 | 1 | 20 |
| Busa et al. [31] | 0 | 1 | 1 | 1 | 1 | 1 | U | 1 | 1 | U | 1 | 1 | 1 | 20 |
| Chumanov et al. [32] | 0 | 1 | 1 | 1 | 1 | 1 | U | 1 | 1 | U | 1 | 1 | 1 | 20 |
| dos Santos et al. [34] | 0 | 1 | 1 | 1 | 1 | 1 | U | 1 | 1 | U | 1 | 1 | 1 | 20 |
| dos Santos et al. [33] | 0 | 1 | 1 | 1 | 1 | 1 | U | 1 | 1 | U | 1 | 1 | 1 | 20 |
| Hunter and Smith [42] | 0 | 1 | 1 | 1 | 1 | 1 | U | 1 | 1 | U | 1 | 1 | 1 | 20 |
| Lenhart et al. [36] | 0 | 1 | 1 | 1 | 1 | 1 | U | 1 | 1 | U | 1 | 1 | 1 | 20 |
| Lieberman et al. [37] | 0 | 1 | 1 | 1 | 1 | 1 | U | 1 | 1 | U | 1 | 1 | 1 | 20 |
| Wang et al. [38] | 0 | 1 | 1 | 1 | 1 | 1 | U | 1 | 1 | 0 | 1 | 1 | 1 | 20 |
| Wellenkotter et al. [39] | 0 | 1 | 1 | 1 | 1 | 1 | U | 1 | 1 | U | 1 | 1 | 1 | 20 |
| Yong et al. [41] | 0 | 1 | 1 | 1 | 1 | 1 | U | 1 | 1 | U | 1 | 1 | 1 | 20 |
| Baggaley et al. [44] | 0 | 1 | 1 | 1 | 1 | 1 | U | 1 | 0 | 0 | 1 | 1 | 1 | 19 |
| Hafer et al. [47] | 0 | 1 | 1 | 1 | 1 | 1 | U | 1 | 0 | 0 | 1 | 1 | 1 | 19 |
| Heiderscheit et al. [49] | 0 | 1 | 1 | 1 | 1 | 1 | U | 1 | 1 | U | 1 | 1 | 1 | 19 |
| Huang et al. [50] | 0 | 1 | 1 | 1 | 1 | 1 | U | 1 | 1 | U | 1 | 1 | 1 | 19 |
| Lenhart 2014 et al. [51] | 0 | 1 | 1 | 1 | 1 | 1 | U | 1 | 1 | U | 1 | 1 | 1 | 19 |
| Lenhart et al. [52] | 0 | 1 | 1 | 1 | 1 | 1 | U | 1 | 1 | U | 1 | 1 | 1 | 19 |
| Neal et al. [55] | 0 | 1 | 1 | 1 | 1 | 1 | U | 1 | 0 | 0 | 1 | 1 | 1 | 18 |
| Swinnen et al. [26] | 0 | 1 | 1 | 1 | 1 | 1 | U | 1 | 1 | U | 1 | 1 | 1 | 19 |
| Zimmerman et al. [57] | 0 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 0 | U | 1 | 1 | 1 | 19 |
| Adams et al. [43] | 0 | 1 | 1 | 1 | 1 | 1 | U | 1 | 0 | 0 | 1 | 1 | 1 | 18 |
| Bramah et al. [23] | 0 | 1 | 1 | 1 | 1 | 1 | U | 1 | 0 | 0 | 1 | 1 | 1 | 18 |
| Garofolini et al. [58] | 0 | 1 | 1 | 1 | 1 | 1 | U | 1 | 0 | 0 | 1 | 1 | 1 | 18 |
| Halvorsen et al. [48] | 0 | 1 | 1 | 1 | 1 | 1 | U | 1 | 0 | 0 | 1 | 1 | 1 | 18 |
| Hobara et al. [25] | 0 | 1 | 1 | 1 | 1 | 1 | U | 1 | 1 | U | 1 | 1 | 1 | 18 |
| Mercer et al. [53] | 0 | 1 | 1 | 1 | 1 | 1 | U | 1 | 0 | 0 | 1 | 1 | 1 | 18 |
| Morin et al. [54] | 0 | 1 | 1 | 1 | 1 | 1 | U | 1 | 1 | U | 1 | 1 | 1 | 18 |
| Quinn et al. [56] | 0 | 1 | 1 | 1 | 1 | 1 | U | 1 | 0 | 0 | 1 | 1 | 1 | 18 |
| Clarke et al. [45] | 0 | 1 | 1 | 1 | 1 | 1 | U | 1 | 1 | U | 1 | 1 | 1 | 17 |
| Connick and Li [46] | 0 | 1 | 1 | 1 | 1 | 1 | U | 1 | 1 | U | 1 | 1 | 1 | 17 |
| Dewolf and De Jaeger [24] | 0 | 1 | 1 | 1 | 1 | 0 | U | 1 | 0 | 0 | 1 | 1 | 1 | 16 |
Item 5 assessed as yes = 2, partial = 1, no = 0, unclear = U. All other items are assessed as yes = 1, no = 0, unclear = U. High-quality scores ≥ 20, moderate -quality scores = 17 to 19, and low-quality scores ≤ 16