Impact of quality items on study outcome - Treatments in acute lateral ankle sprains

Objective: This study investigates the influence of different aspects of me thodologic quality on the conclusions of a systematic review concerning tre atments of acute lateral ankle sprain. Method: A data set of a systematic review of 44 trials was used, of which 2 2 trials could be included in this study. Quality assessment of the individ ual studies was performed using the Delphi list. We calculated effect sizes of the main outcome measure in each study in order to evaluate the relatio nship between overall quality scores and outcome. Next, we investigated the impact of design attributes on pooled effect sizes by subgroup analysis. Results: The quality of most studies (82%) was low; only 4 of 22 trials wer e of high quality. Studies with proper randomization and blinding procedure produce a slightly higher (not statistically significant) effect estimate compared to the other studies. Conclusion: Previous research has suggested that methodologically poorly de signed studies tend to over-estimate the effect estimate. Our study does no t confirm these conclusions.