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Table 5 Quality rating of observational studies

From: Manual therapy for the pediatric population: a systematic review

Author/year Study design type Condition sample size (n) Result summary Intervention Include/exclude Recruitment strategy Comparison selection Blinded outcome assessor(s) Valid, reliable measures Length of follow-up Missing outcomes Missing harms/ adverse events Missing confounding variables Overall quality rating
Gastrointestinal/Urinary
 Tarsuslu T, et al. 2009 [18] Interrupted time series (with comparison group) Constipation and Cerebral Palsy (n = 13) No difference OMT L does not vary H not described H not described H not blinded U-PN property measurements not fully evaluated for children L consistent L all outcomes discussed H adverse events not reported U-PN dietary Medium
 Wiberg K & Wiberg J, 2010 [20] Interrupted time series (without a comparison group) Infantile colic (n = 749) No improvement CMT NA NA NA H not blinded U-PN property measurements not fully evaluated for children H not discussed L all outcomes discussed H adverse events not reported U- PN co-interventions missing Low
 van Poecke A & Cunliffe C, 2009 [25] Before-after Nocturnal Enuresis (n = 33) Improvement CMT NA NA NA H not blinded U-PN property measurements not fully evaluated for children L consistent L all outcomes discussed H adverse events not reported U- PN dietary Medium
 Miller J, et al. 2009 [26] Before-after Suboptimal Infant Breastfeeding (n = 114) Improvement CMT NA NA NA H not blinded U-PN property measurements not fully evaluated for children H not discussed L all outcomes discussed L adverse events reported L confounding variables accounted for Medium
 Vallone S, 2004 [27] Before-after Suboptimal Infant Breastfeeding (n = 25) Improvement CMT/CST NA NA NA H not blinded U-PN property measurements not fully evaluated for children H not discussed U-PN different outcomes for participants H adverse events not reported H no confounding variables included Low
Musculoskeletal
 Jennings J & Davies G, 2005 [29] Interrupted time series (without comparison group) Cuboid Syndrome (n = 2) Improvement MT NA NA NA H not blinded U-PN property measurements not fully evaluated for children U-PY not different but not specified L all outcomes discussed H adverse events not reported U-PN variables that may influence outcome discussed but no adjustment to outcome taken into account Medium
 Przekop P, et al. 2016 [30] Before-after Chronic tension-type headache (n = 83) Improvement OMT NA NA NA H not blinded U-PN property measurements not fully evaluated for children L consistent L all outcomes discussed H adverse events not reported L confounding variables accounted for Medium
 Marchand A, et al. 2009 [32] Before-after Benign infant headache (n = 13) Improvement CMT NA NA NA H not blinded U-PN property measurements not fully evaluated for children H not discussed L all outcomes discussed H adverse events not reported H medication not accounted for Low
 Walston Z & Yake D, 2016 [34] Interrupted time series (without comparison) Mechanical Low Back Pain (n = 3) Improvement MT NA NA NA H not blinded U-PN property measurements not fully evaluated for children H not consistent L all outcomes discussed L adverse events reported U-PN information not consistently collected Medium
 Hayden J, et al. 2003 [36] Before-after Mechanical Low Back Pain (n = 54) Improvement CMT NA NA NA H not blinded U-PN property measurements not fully evaluated for children L consistent U-PN not all cases collected H adverse events not reported U-PY retrospective data, information not consistently collected Medium
Respiratory
 Degenhardt B & Kuchera M, 2006 [45] Before-after Otitis media (n = 8) Improvement OMT/CST NA NA NA H not blinded U-PN property measurements not fully evaluated for children L consistent L all outcomes discussed H adverse events not reported U-PN natural course of OM diagnosis, differences in AOM and OM, dietary considerations Medium
 Zhang JQ & Snyder BJ, 2004 [46] Before-after Otitis media (n = 22) Improvement CMT NA NA NA H not blinded U-PN property measurements not fully evaluated for children H not discussed L all outcomes discussed L adverse events reported H several confounding varaibles missing Medium
Special Needs
 Bramati-Castellarin I, et al. 2016 [49] Interrupted time series (without comparison) Autism (n = 49) Improvement VOMT NA NA NA H not blinded U-PN property measurements not fully evaluated for children L follow up consistent L all outcomes discussed H adverse events not reported U-PY not all confounding variables known Medium
Structural
 Lessard S, et al. 2011 [59] Before-after Cranial asymmetry (nonsynostotic plagiocephaly) (n = 12) Improvement OMT NA NA NA L blinded U-PN property measurements not fully evaluated for children L follow-up consistent L all outcomes discussed H adverse events not reported U-PN natural course Medium
 Byun S & Han D, 2016 [61] Before-after Scoliosis (n = 5) Improvement CMT NA NA NA H not blinded L Cobb angle L follow-up consistent L all outcomes discussed H adverse events not discussed H confounding variables not accounted for, no mention of natural course Medium
 Morningstar M, et al. 2004 [63] Before-after Scoliosis (n = 6) Improvement CMT NA NA NA H not blinded L Cobb angle H length of follow-up similar but some patients had received prior treatment L all outcomes discussed H adverse events not reported H confounding variables not accounted for, no mention of natural course Low
 Lantz C & Chen J, 2001 [64] Before-after Scoliosis (n = 42) No improvement CMT NA NA NA L blinded L Cobb angle H follow-up not consistent L all outcomes discussed H adverse events not reported H confounding variables missing, no mention of natural course Medium
 Saedt E, et al. 2018 [67] Before-after Upper cervical dysfunction (n = 307) Improvement MT NA NA NA L blinded U-PN property measurements not fully evaluated for children L follow-up consistent L all outcomes discussed L adverse events discussed U-PY not all confounding variables known High
  1. Legend: H-High risk of bias; L-Low risk of bias; NA-Not applicable; U-Unclear; PN-Probably No (high risk of bias); PY-Probably Yes (low risk of bias)
  2. Interventions: CMT Chiropractic Manipulative Therapy, CST Craniosacral Therapy, MT Manual Therapy, OMT Osteopathic Manipulative Therapy