From:  An exploratory narrative review of the symbiosis between intervention and patient education and how they improve pain-related disability

 Limitations of evidence.

ArticleLimitations
Meeus et al. [28]

  • Too short a period of follow-up time

  • Changes could be better evaluated if a longer intervention period were allowed

Fletcher et al. [29]

  • Modest sample size included; power calculation was not used, potentially leading to unreliable, inconclusive results

  • Lack of a control group, leading to further uncertainty and potential bias

Darnall et al. [30]

  • Self-reported results/outcomes at a single study site led to bias

  • Selection bias caused by the majority of participants being ‘white individuals’; therefore, data may not be generalisable

Sandhu et al. [31]

  • Participants were not blinded to group assignment, leading to bias

  • Self-reported use of opioids not being confirmed by blood/urine analysis pre-study, potentially not generalisable data

Traeger et al. [32]

  • Participants not blinded to treatment allocation led to bias

  • Change in practitioners (physio and health practitioner) could lead to varying results, weakening validity

Linton and Andersson [34]

  • 29 participants didn’t complete, limiting the results

  • More follow-ups were required, leading to attrition and procedural bias

Zgierska et al. [36]

  • Bias caused by non-blinding group allocation ‘self-selection’

  • Small sample size led to limitations

Deshpande et al. [35]

  • Some missing data led to bias, and some assessors’ awareness of the participants’ assignment

Geneen et al. [37]

  • Assessments were too widely variable, potentially a limited study design

  • Too small a sample size, poor generalisability, and sampling bias

Trouvin et al. [39]

  • Some participants did not complete follow-up, leading to attrition bias

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