Concerns on the evidence used to challenge established guidelines – Authors' reply
Stijn de Jonge and colleagues have raised several important points regarding our meta-analysis.1 In recent years, several systematic reviews have been published that provide a comprehensive overview of existing data, including low-quality randomised trials. However, a meta-analysis of studies at high risk of bias merely amplifies bias.2 Rather than duplicating previous reviews, we preplanned to restrict our analysis to high-quality studies that would provide a rigorous basis for clinical practice recommendations.
Source: thelancet.com