According to the JADAD score
, eleven RCTs were assessed as high quality with Jaded score [greater than or equal to] 3.
For published trials of pharmacological approaches, the mean Jadad score
was 4.0[+ or -]1.4.
The mean Jadad score
of the studies included was 2.6 points.
The quality of each study was also assessed using the Jadad score
, which examines withdrawals, blinding, and randomization of a study , although studies were not excluded on the basis of this assessment.
Fourth, most studies had a low quality with Jadad score
[less than or equal to] 2.
To ascertain the validity of the eligible RCTs, the methodological quality of the included studies was assessed independently by two reviewers (Pajaree Sriuttha and Buntitabhon Sirichanchuen) using the Jadad score
The Jadad score
was used for analyzing the methodological quality of the meta-analysis and in evaluating and summarizing the 6 studies.
J: Jadad score
; FP: fluticasone propionate; SAL: salmeterol xinafoate; SFC: combination of salmeterol xinafoate and fluticasone propionate; BDP: beclomethasone dipropionate; FOR: formoterol; TIO: tiotropium; UMEC: umeclidinium; QVA149: combination of indacaterol (a long-acting agonist) with glycopyrronium (a long-acting muscarinic antagonist) as a dual bronchodilator; FF: fluticasone furoate; VI: vilanterol; NA: not applicable.
Appendix A: quality assessment of the included studies according to modified jadad score
. Appendix B: forest plots of primary outcomes (pain).
Firstly, due to limited conditions, only PubMed, The Cochrane Library, EM base, SCI, CNKI, Wan Fang Data, and VIP were searched, and there might be omissions; secondly, the quality of included papers was low, the random distribution method and blind method was not described, some trials failed to indicate whether there was missing subject, only indicating random distribution, and the modified Jadad score
of most trials was 2; thirdly, the heterogeneity of included studies was quite large, only random-effect model could be adopted, which had certain impact on the results; fourthly, there was a large possibility of publication bias among included trials.
The Jadad score
is obtained from a possible 5-point scale; high scores indicating high quality, by yes/no answers to question for randomisation and blinding, and one question evaluating the reporting of patient withdrawals and dropouts.
All studies were assigned a Jadad score
of [greater than or equal to]3, while five studies received a score of <4.