The quality of available evidence overall was of poor to moderate quality according to the Downs and Black criteria; and therefore further research of higher methodological quality
is required before strong recommendations can be made regarding the effect of aquatic-based exercise on exercise tolerance and HRQOL in patients with stable CHF.
Contents Introduction Methods Database and search strategies Inclusion criteria Data extraction and quality assessment Data synthesis Results Description of included trials Methodological quality
of included trials Effect of the interventions Publication bias Adverse effect Discussion Conclusion Conflict of interest References
Regardless of whether methodological quality
influenced the findings associated with immediate posttest results, low-risk students exposed to treatment were found to have lower levels of anxiety at follow-up data collection periods occurring within 12-months of program completion than students not exposed to treatment.
The methodological quality
of the included studies was assessed using a checklist recommended by the Cochrane Collaboration based on the QUADAS.
However, the biggest obstacle for generating high-quality, clinically useful diagnostic reviews is the poor methodological quality
of the existing body of diagnostic accuracy studies reported in the literature.
The first author re-appraised the included studies for evidence a third time with the criteria as recommended by the American Dietetic Association evidence analysis manual (ADA 2005:26-33; ADA 2008:42-46), to confirm methodological quality
ratings and to check consistency in ratings of included studies for data extraction and analysis of evidence.
2007) developed the Medical Education Research Study Quality Instrument (MERSQI) to measure the methodological quality
of educational research.
A common feature of a systematic review is formal assessment of the methodological quality
of the individual studies that it includes.
For example, Fink explains the importance of how methodological quality
indicates how well a study has met its goals, regarding its design and implementation.
MAIN RESULTS: Five studies met inclusion criteria for the review, however, methodological quality
was highly variable.
Assessing the methodological quality
of the articles
A more significant consequence of not publishing these works in scientific journals is that most of the studies have not survived a critical peer review Thus, the methodological quality
of much of this literature is either weak or unknown (Arthur 2001; Myers 1984; Pompe and Sharar 2008).
Included studies were assessed by two independent reviewers for methodological quality
prior to inclusion in the review using an appraisal checklist developed for the review based on the reviews of Zwakhalen et al to evaluate validity, reliability and feasibility.
In general, inter-rater reliability was found to be poor and studies were of poor methodological quality
Only one of these publications met all three key methodological quality
criteria appropriate for meta-analyses (20).