Which has higher evidence and value? SR of few (1-2) RCT or many CCT? Or combine both? And what critical appraisal tool can be used for both RCT and CCT in one review.
Heba Huessin,
Of course, a review of RCTs is considered higher evidence but under powered with only 2. My suggestion is to perform TWO systematic reviews. After you complete (and publish) the reviews, use them to complete an all encompassing review. This will allow you to maintain level of evidence in your reviews and produce a "whole" story. In my opinion.... Regards.
Alternatively you could do a review of all studies and then include a subgroup analysis (albeit underpowered) of just the two RCTs. I would then analyse each individual outcome.
Outcomes are grouped together and given a level of evidence ranking based on the collective strength of evidence(ref attached):
1. Strong evidence: two or more high quality (quality score
≥4) RCTs with ≥75% consistency in findings.
2. Moderate evidence: one high quality RCT and two or more
low quality studies with ≥75% consistency in findings.
3. Weak evidence: one high quality RCT or multiple low
quality studies with ≥75% consistency in findings.
4. Conflicting evidence: multiple low and/or high quality
studies with ≤75% consistency in findings.
5. No evidence: no studies could be found, may include
technique reports.
Alternatively if there is consistent reporting of outcomes a meta-analysis would be better and is very simple using Revman a free program from the cochrane collaboration.
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