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Comparative efficacy and acceptability of non-surgical brain stimulation for the acute treatment of major depressive episodes in adults: systematic review and network meta-analysis

BMJ 2019; 364 doi: https://doi.org/10.1136/bmj.l1079 (Published 27 March 2019) Cite this as: BMJ 2019;364:l1079

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Re: Comparative efficacy and acceptability of non-surgical brain stimulation for the acute treatment of major depressive episodes in adults: systematic review and network meta-analysis

Dichotomizing risk of bias was not appropriate

The authors write in their abstract that, "The quality of the evidence was typically of low or unclear risk of bias (94 out of 113 trials, 83%)." It is inappropriate to divide a three-category risk of bias assessment of the primary studies in this way. Studies with unclear risk of bias often have a high risk of bias. Therefore, the proper information is to note the number of studies which are of low risk of bias.

Competing interests: No competing interests

15 April 2019
Peter C Gøtzsche
Professor
Institute for Scientific Freedom