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Letters Effect of recessions on health

Editorial authors’ reply to Barlow

BMJ 2016; 355 doi: (Published 16 December 2016) Cite this as: BMJ 2016;355:i6638
  1. Ben Barr, senior clinical lecturer in applied public health1,
  2. David Taylor-Robinson, senior clinical lecturer in public health2
  1. 1Department of Public Health and Policy, University of Liverpool, Liverpool L69 3GB, UK
  2. 2Department of Public Health and Policy, The Farr Institute@HeRC, Liverpool, UK
  1. b.barr{at}

We thank Barlow for his comment on our commentary about the systematic review by Parmar and colleagues.1 2 3 Barlow suggests that our studies4 5 6 may have been excluded from Parmar and colleagues’ review on the basis of their risk of bias assessment: this is not the case. As is clear from figure 1 in the paper by Parmar and colleagues, no studies were excluded on the basis of the risk of bias assessment. This, however, highlights the issue we raise in the commentary. Because the exposure of interest—the financial crisis—is poorly defined, the evidence is difficult to synthesise and interpret. In particular, this presents problems in deciding which search terms should …

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