"Although we defined high quality studies as those that scored full marks on the Newcastle-Ottawa scale, many of these high and medium quality studies probably did not control for all possible confounders. Although we restricted positive cannabis results to drivers that showed the presence of tetrahydrocannabinol in the absence of other drugs or alcohol, other potentially important confounders were probably not controlled for. These hidden confounders, as well as the differing study designs used, might have affected the results of the individual studies and hence the estimates of the pooled odds ratios." M. Asbridge, J. Hayden, J. Cartwright (2012) Acute cannabis consumption and motor vehicle collision risk: systematic review of observational studies and meta-analysis. BMJ 2012;344:e536 doi: 10.1136/bmj.e536 

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