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Dear Kev and all, Thank you for all the great papers on bias and effect size. At first my linear thinking did not understand the concept reasoning that if the effect size was artificially inflated and was as a result not apparent when good methods were practiced then it was not an effect size. I was particularly impressed with the acupuncture example in which I agree with the authors of this paper, the claims were a major extrapolation and the lack of bias controls distorted outcomes. I like the idea of the sensitivity analysis which lays out clearly where conclusions came from and why. I do have a couple of questions: What is to be done if there are no real studies on the population group the research question is assessing. For example I am looking at computer based cognitive not psychosocial brain training in substance abuse. There are studies for other populations but not this one. What are the implications in terms of validity for using another population? Secondly in the sensitivity analysis where does expert vs non expert practitioner fit. For instance in many mental health or even acupuncture interventions practitioner skill matters. But if we use something more objective such as artificial disk implantation in surgery for example success rates may be correlated with number of surgeries performed. How could this be controlled for in the area of negative bias if one is looking at existing trials without consideration of operator expertise? Third is it acceptable to state acupuncture as an effective primary intervention for stroke rehabilitation was not found to be useful however studies did show that as a method of short term pain control or as an adjunct to increasing circulation this may be a viable research question to explore in terms of intervention? Thanks for your views on this, your input has really helped me to adjust the way I see research. Best Regards, Amy From: Evidence based health (EBH) [mailto:[log in to unmask]] On Behalf Of k.hopayian Sent: 02 January 2012 03:32 AM To: [log in to unmask] Subject: Re: Reference on Methodology relationship to Effect Size Hi Robert, This one looked at quality of study and effect for acupuncture: Smith LA, Oldman AD, McQuay HJ, Moore RA. Teasing apart quality and validity in systematic reviews: an example from acupuncture trials in chronic neck and back pain. Pain. 2000;86(1-2):119-132. Kev Dr Kev (Kevork) Hopayian, MD FRCGP General Practitioner, Leiston, Suffolk Hon Sen Lecturer, Norwich Medical School, University of East Anglia Primary Care Tutor, Suffolk Surgery Tel +44 1728 830526 Surgery Fax +44 1728 832029 [log in to unmask] http://www.angliangp.org.uk/ Making your practice evidence-based http://www.rcgp.org.uk/bookshop On 1 Jan 2012, at 18:11, Weyant, Robert J wrote: I would appreciate it if list members might have references to pubs that document that effect size declines with improved research methodology. _____________________________ Robert J. Weyant, DMD, DrPH Professor and Chair Department of Dental Public Health and Information Management 346 Salk, School of Dental Medicine University of Pittsburgh Pittsburgh PA 15261 Office Phone: (412) 648-3052 DPH Departmental Administrator: (412) 648-3534 Google Phone: (412) 423-8495 Editor-in-Chief Journal of Public Health Dentistry www.blackwellpublishing.com/jphd DPH Listserve (subscribe/unsubscribe): <http://list.pitt.edu/mailman/listinfo/dental-public-health> http://list.pitt.edu/mailman/listinfo/dental-public-health DPH Password Reminder: <https://list.pitt.edu/mailman/options/dental-public-health> https://list.pitt.edu/mailman/options/dental-public-health This email may contain confidential information of the sending organization. Any unauthorized or improper disclosure, copying, distribution, or use of the contents of this email and attached document(s) is prohibited. The information contained in this email and attached document(s) is intended only for the personal and confidential use of the recipient(s) named above. If you have received this communication in error, please notify the sender immediately by email and delete the original email and attached document(s). (W)