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The following literature review is based on a comparative literature review which highlights the traditional methods of Infantile Colic Relief while contrasting these with manual treatments. This report is based on a detailed literature review synthesizing findings from published research. The essay is divided into three sections; introduction, central review and conclusion, and the summary table of the published articles is used to explain the review. The essay is mainly related to infantile colic and the prevalence of manual therapies that can improve the quality of life for both parents and infants. According to Skjeie et al. (2013), infantile colic is a distressing condition characterized by excessive crying in the first few months of birth. It is also known as the self-limiting condition which occurs in infants and is considered a common disturbance. However, the exact aetiology is still undiscovered. Moreover, it is associated with the malicious cycle of infant crying.
To prevent this, the mothers use different methods for Infantile Colic Relief to relieve the infants from this condition. However, there has been limited evidence regarding the support of complementary and alternative treatment usage or behavioural intentions. There are several approaches to deal with this disorder, including probiotics as the conventional one and manual therapy as the most recommended option, including chiropractic, massage, and osteopathy (Sheidaei, 2016). Per the research conducted by Steel (2011), osteopathy is a medical care system practised by people in several countries across the globe. The fundamental objective of this technique is to conduct osteopathic manual practices into the medical interventions suggested by the consultants.
Background
Infantile colic is regarded as a common condition which is defined as the colicky crying of infants. The crying mainly starts from the first few weeks of birth and spontaneously resolves within two to five months. In addition, excessive crying is explained as crying lasting more than 3 hours daily or more than three days weekly. It has been attributed to the study conducted by Gutiérrez-Castrellón et al. (2017) that infantile colic can be diagnosed with intestinal contractions, the presence of gas in the gut, lactose intolerance and misinterpretation of normal crying of the paternal. However, in recent times, it has been hypothesized as the medical or behavioural cause. In addition, the medical hypothesis has also included food hypersensitivity or allergies which can cause severe infant problems. In this regard, most parents seek advice from doctors or look for counter remedies for infantile colic relief. Posadzki, Lee and Ernst (2013) have reflected that manual therapies are likely more effective than traditional methods such as massage, osteopathy and chiropractic.
Study rationale
The following topic has been selected because there are specific gaps in the studies conducted. After all, those studies do not provide a definite conclusion as to how manual therapies can be more effective than traditional methods. This can also be evidenced by the survey of Bronfort et al. (2010), which highlights that despite the diverse strategies and therapies used globally for curing infantile colic, the efficacy of each intervention is still questionable and subject to dispute. In European countries, various treatments, including spinal manipulation and simethicone, effectively reduce infantile crying. However, a conflicting opinion regarding the efficacy of such treatments exists. Considering the lack of proven facts and evidence, the effective treatment for infantile colic, traditional methods, and manual therapies have been spotlighted. A study suggests that herbal supplements are adequate for preventing stomach aches in infants. The study also suggests infantile colic relief through acupuncture which effectively helps in reducing pain. In light of this discussion, this study has reviewed different articles on infantile colic therapies along with the cases to assess the effectiveness of traditional and manual treatments.
Statement of Research Question
The research question which is designed for this assessment is as follows:
- How can the efficacy of traditional methods of infantile colic relief be compared with manual treatment?
Literature review
Study evaluation
The study by Hayden (2009) entitled “: A preliminary assessment of the impact of cranial osteopathy for the relief of infantile colic” was based on the findings comprised of 28 infants that were suffering from colic, and thus, few of them were provided with osteopathic manipulation. To determine the significance of the treatment, parents were engaged in observing their children based on their time spent crying and sleeping. Upon examining the results, it was found that children's time crying significantly reduced in the fourth week compared to what was recorded in the first week. Further, significant improvement in the time spent sleeping was also observed. It was also found that the infants provided with osteopathic treatment also required less parental attention than the other group. Conclusively, it has been summarised by the researcher that osteopathic treatment for infantile colic relief offers benefits in the treatment of colic.
The study of Sheidaei (2016) was concerned with determining the effectiveness of massage therapy in infantile colic symptoms. The study discusses that infantile colic raises issues like cry-fuss and sleep problems that eventually affect mental health problems besides its adverse effects on the child's physical and psychological growth. In this regard, the researcher intended to determine the efficacy of massage therapy compared to rocking to reduce infantile colic symptoms such as cries, sleep and severity of infant colic. The findings of this study were based on 100 infants younger than 12 years. The infants were randomly assigned to the groups that were the massage group and the rocking group. The infants were provided massage day and night for 15-20 mint. On the other hand, mothers were also asked to rock infants gently for 5-25 minutes. The study found that the efficiency of massage therapy was considerably higher than that of rocking. The study suggested that massaging significantly improves colic symptoms provided with the one-week intervention, resulting in infantile colic relief. The researcher also found a significant difference between intervention and control groups, whereas the experiment was associated with massaging. In this aspect, the researcher has suggested that massaging therapy is more effective than rocking in treating colic symptoms among infants.
The study of Castejón-Castejón (2019) was inclined toward determining the effectiveness of craniosacral therapy (CST) to facilitate the treatment of infantile colic. The study’s findings were based on the observations collected for 58 infants diagnosed with infantile colic. The observations from infants were collected four times a day. Additionally, the results were supported by the colic severity measure, designed as an infant colic severity questionnaire. The study found a statistical difference between the two groups from the perspectives of crying hours, sleep hours, and colic severity. The study encases the findings by suggesting craniosacral therapy is a more effective and safe option for infantile colic because of its significance in reducing the number of crying hours and colic severity and increasing total hours of sleep.
The study of Miller, Newell and Bolton (2012) was concerned with determining the efficacy of chiropractic manual therapy for infants with unexplained crying behaviour. The study was also concerned with determining whether this manual therapy is linked to parental reporting bias. The infants were randomized into three groups: infant treated, parent aware, and neither infant treated nor familiar. Based on one hundred and four patients suggests that chiropractic manual therapy improves crying behaviour among infants with colic. The study's findings indicate that knowledge of treatment possessed by parents does not influence the effectiveness of the treatment.
The study of Salvatore (2016) is devoted to exploring pharmacological interventions for early functional gastrointestinal disorders. The study discusses that functional gastrointestinal disorders are chronic symptoms without structural or biochemical abnormalities. Further highlighting the need for curing functional gastrointestinal disorders, the researcher suggests that FGID are multifactorial conditions with different pathophysiologic mechanisms, namely motility, brain-gut disturbance, and environmental and psychological factors. The study's findings were based on secondary research where it has been found that pharmacological intervention is essential for rectal disimpaction in childhood constipation. However, the study did not find any use of pharmacological therapy for the treatment of this particular disease.
Another article presented by Holm (2018) focused on the effects of chiropractic treatment for infantile colic. The study used the single-blind RCT protocol to reflect the findings related to the selected treatment method. The present study discusses infantile colic, which is known as a common condition found in early childhood that can influence newborns. Although the cause of colic can sometimes be unknown, the hypothesis has been evidenced in a different treatment effective for infantile colic. The study also suggests that chiropractic is mainly utilized for treating infantile colic; however, the evidence for its effectiveness is sparse. This study undertook a single-blind randomized control trial and invited families having children aged 2-14 weeks with extreme crying. This study has also proposed an intervention that assesses the influence of chiropractic treatment on infantile colic relievf. In addition to the above statement, the study does not undertake manual treatment as all the children attended a chiropractor clinic two times. After their fourth visit, the children’s burps, colic and bowel movements were examined. A positive result was identified from the chiropractic treatment as the children were not frequently crying because of infantile colic.
Significance of Findings
Several aspects were identified from the findings retrieved from the critical review and evaluation of the articles. For instance, the principle of osteopathic manual practices encodes that the practitioner should keep a thin mind while treating a patient, whether a paediatric or pregnant or any other category, that their whole body is a single unit, and whatever the treatment is suggested, it should not become the reason for stagnation. Similarly, chiropractic manual therapy is used in the research conducted by Miller (2012) to cure the conditions of repetitive crying and other discomforts of babies like infantile colic. However, the research undertaken by Hayden (2009) presents a controlled and open study over a selected sample group of patients, which includes 28 infants who are diagnosed with colic (Steel, 2017).
Along these lines, the study introduced by Sheidaei (2016) led to a model of training in which newborn children with colic are exposed to treatment with their foreboding through back rub treatment or massages in different areas. It is seen that children who get massaged all the time have improved their well-being more quickly. Additionally, according to the comprehension of the study directed by Castejón (2019), minors treated with Chiropractic manual treatment improved their well-being and resulted in infantile colic relief. Moreover, infantile colic or the disorder of infant colic is a condition wherein a child cries either during the day or night, while the latter is more common. Although the outcomes are not severe, the guardians and parents encounter uneasiness, stress and sorrow because of the uncontrolled crying of their babies (Castejón, 2019). Doctors have recommended various conventional methodologies using which the child can get loose in their prolonged wheezing pain. However, a few elective clinical intercessions and manual procedures are increasingly productive in managing the circumstance. According to the study by Miller, Newell and Bolton (2012), it has been identified that the RCT design helped evaluate the effectiveness of chiropractic treatment for infantile colic. Moreover, the study contributed to the determination of the influence of this treatment on colic conditions to fill in the literature gap. Furthermore, the study explored whether the subgroups of the children are suspected of problems which can benefit from the intervention and help achieve better results.
Quality Criteria Of Chosen Articles
The quality of the selected articles was thoroughly assessed through the use of the Risk of Bias (ROB) tool with the Cochrane Collaboration, where each domain was graded with High Risk (H), Unclear (U), or Low Risk (L). In addition, the articles selected above assessed certain domains such as sequence generation, blinding of participants, research personnel, outcomes, incomplete data, and other biases. Moreover, for the selective reporting procedures, the study protocols were located and graded as L if no differences were identified between the results and protocol. Since different outcomes were expected, an assessment was conducted that estimates the Risk Ratio (RR) for the continuous outcomes that are dichotomous to achieve. Moreover, if clinical and statistical heterogeneity was observed, then different studies were also reviewed to recheck the findings and method of data collection.
Conclusion
In conclusion, it can be summarized that the manual practice of osteopathy is generally a non-aggressive therapy that includes treating through the hands. The above study selected infantile colic as the subject and discovered the impact of osteopathy on the therapeutic approach to the disorder. Although certain medications can cure colic to some extent, manual techniques like massage and any other osteopathy approach show excellent general results. While considering the findings mentioned above, it can be suggested that manual therapy can be essential and effective while treating infants with colic. Several studies have suggested that osteopathic approaches and treatment techniques can be beneficial while treating colic among infants. The studies have been executed in the context of infants where the significance of osteopathic approaches. More specifically, various massaging techniques and other treatments for infantile colic have been found as significant for treatments.
Summary of Findings
While considering the findings of Hayden (2009), it can be deduced that infants that were provided osteopathic treatment against infantile colic required less parental attention. This helped the researcher conclude that osteopathic treatment benefits the treatment of colic among infants. Further, upon encasing the findings, Sheidaei (2016) found that massage therapy is clinical in eradicating colic symptoms. The researcher executed secondary research where it has been found that massage therapy is more beneficial in comparison to rocking while discussing the treatment of colic symptoms. Castejón-Castejón (2019) findings have suggested that craniosacral therapy is found to have a more effective and beneficial way of treating infantile colic. The study revealed that craniosacral therapy helps in reducing the number of crying hours and colic severity and consequently helps increase total hours of sleep. Miller, Newell, and Bolton (2012), in their research involving 104 infants, found that chiropractic manual therapy helps improve the crying behaviour of infants having an issue with colic. The study of Salvatore (2016) was concerned with exploring pharmacological interventions. The study found that pharmacological intervention is essential for rectal disimpaction in childhood constipation. Nonetheless, the study did not find that pharmacological treatment can effectively treat any other disease. Holm (2018) has focused on the effects of chiropractic treatment for infantile colic. The study suggested that chiropractic is mainly utilized for treating infantile colic; however, the evidence for its effectiveness is sparse.
The relevance of the Research
- The current study has referred to six different studies where the prime focus of the researcher was to explore effective treatment that can aid in the treatment of infantile colic. The current study is significant for several stakeholders, such as Patients and the Public.
- The researcher has strived to inform the patients and the public about using osteopathy, massage, and related treatments while curing infantile colic. The study provides information regarding novel solutions for curing infantile colic, such as Osteopathy.
- The study sheds light on the significance of osteopathy and intends to provide empirical evidence that justifies the importance of osteopathy while treating infantile colic. The study mainly promotes and showcases the contribution osteopaths can make in this field of interest, such as Manual Therapist.
- In a true sense, the study highlights what therapy and massage treatment can bring about in the treatment of infantile colic, especially for Health Care Communities.
- The study also highlights the usefulness of osteopathy and related massage therapies for treating infantile colic. In this regard, the study suggests health care communities promote the culture of osteopathic and massage treatment besides relying on pharmacological intervention while treating infantile colic.
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References
Bronfort, G., Haas, M., Evans, R., Leininger, B. and Triano, J., 2010. Effectiveness of manual therapies: the UK evidence report. Chiropractic & osteopathy, 18(1), p.3.
Castejón-Castejón, M., Murcia-González, M.A., Gil, J.M., Todri, J., Rancel, M.S., Lena, O. and Chillón-Martínez, R., 2019. Effectiveness of craniosacral therapy in the treatment of infantile colic. A randomized controlled trial. Complementary therapies in medicine, 47, p.102164.
Gutiérrez-Castrellón, P., Indrio, F., Bolio-Galvis, A., Jiménez-Gutiérrez, C., Jimenez-Escobar, I. and López-Velázquez, G., 2017. Efficacy of Lactobacillus reuteri DSM 17938 for infantile colic: Systematic review with network meta-analysis. Medicine, 96(51).
Hayden, C. and Mullinger, B., 2009. Reprint of: A preliminary assessment of the impact of cranial osteopathy on the relief of infantile colic. Complementary therapies in clinical practice, 15(4), pp.198-203.
Holm, L.V., Jarbøl, D.E., Christensen, H.W., Søndergaard, J. and Hestbæk, L., 2018. The effect of chiropractic treatment on infantile colic: study protocol for a single-blind randomized controlled trial. Chiropractic & manual therapies, 26(1), p.17.
Miller, J.E., Newell, D. and Bolton, J.E., 2012. Efficacy of chiropractic manual therapy on infant colic: a pragmatic single-blind, randomized controlled trial. Journal of manipulative and physiological therapeutics, 35(8), pp.600-607.
Miller, J.E., Newell, D. and Bolton, J.E., 2012. Efficacy of chiropractic manual therapy on infant colic: a pragmatic single-blind, randomized controlled trial. Journal of manipulative and physiological therapeutics, 35(8), pp.600-607.
Posadzki, P., Lee, M.S. and Ernst, E., 2013. Osteopathic manipulative treatment for pediatric conditions: a systematic review. Pediatrics, 132(1), pp.140-152.
Salvatore, S., Barberi, S., Borrelli, O., Castellazzi, A., Di Mauro, D., Di Mauro, G., Doria, M., Francavilla, R., Landi, M., Martelli, A. and Miniello, V.L., 2016. Pharmacological interventions on early functional gastrointestinal disorders. Italian journal of pediatrics, 42(1), p.68.
Sheidaei, A., Abadi, A., Zaveri, F., Nahidi, F., Gazerani, N., and Mansouri, A., 2016. The effectiveness of massage therapy in the treatment of infantile colic symptoms: A randomized controlled trial. Medical journal of the Islamic Republic of Iran, 30, p.351.
Skjeie, H., Skonnord, T., Fetveit, A. and Brekke, M., 2013. Acupuncture for infantile colic: a blinding-validated, randomized controlled multicentre trial in general practice. Scandinavian journal of primary health care, 31(4), pp.190-196.
Appendices
Study | Objective | Methodology | Finding | Conclusion |
Castejón-Castejón (2019) | To evaluate the efficiency of ACT in treating infantile colic | Episodic check-up for progress after implying CST sessions every week in 24 days. There is a randomized trial in which 58 infants are involved that are between 0 to 84 days and are diagnosed with the infantile colic. There is 30 to 40 CST session for every baby in a week. The babies that are in the CST group have received 1 to 3 sessions in 14 days. The data has been collected 4 times a day. | The sleep hour and crying hours are improved in a controlled group. The results of ANCOVA along with the baseline crying which is regarded as the covariate demonstrates the important group which affects the crying hours. The CST group shows improvement in every endpoint. | The CST approach is safe and effective for infantile colic. It mainly reduces the number of hours they spent crying, the colic severity as well as increases the total hours of sleep. |
Hayden (2009) | To distinguish the impact of cranial osteopathy in treating infantile colic | Parents were asked for care and rock their babies before sleep time during the sessional therapeutic routine of cranial osteopathy for four weeks. In this study, 28 infants were involved who are randomized for cranial osteopathic manipulation or they are getting no treatment in the time of 4 weeks. The treatment is as per the findings of individuals who are administrated by a similar practitioner. The parents were asked to record the time babies are spending crying, sleeping, and being held on every day. | Sleep time increased, and crying time decreased. There is an overall declination in the crying which is nearly 63% and 23% for the treated and controlled groups respectively. There is an improvement in sleeping about 11% and 2%. the infants that are treated need less attention from their parents as compared to untreated patients. | It is observed that cranial osteopathy is an effective approach to treating colic. Through this, the infants can relax and cry less and can sleep for a long time. |
Holm (2018) | To evaluate the outcome of chiropractic treatment in curing infantile colic | Selected children were exposed to chiropractic treatment about two times a week, and the results were monitored accordingly. The study is mainly designed as it is single-blind which is randomized as well as controlled. The respondents are families which live on the Island of Funen as well as information regarding the project is mainly distributed from the health visitors and maternity wards. The children that are at age of 2 to 14 weeks who have unexplained excessive crying are screened for eligibility. | Parents reported better sleeping patterns and reduced crying episodes after the sessions. The main thing which is evaluated in the single-blind randomized controlled design is the effectiveness of the treatment depends over chiropractic on infant colic. The main contribution of this study is in the determination of the effect of this treatment on the infantile colic in such areas where there is limited evidence. | My health was improved ad the stress was relieved. Infantile colic is considered the condition which is usually faced while childhood and affects almost one infant out of six infants. This is the condition which is characterized by the crying which is not consolable as well as fussing which otherwise results in healthy as well as thriving infants. |
Miller (2012) | The study aims to distinguish the proficiency of the Chiropractic Manual Therapy in treating infant colic through RTC. The objective of the study is to cure the conditions of repetitive crying and other discomforts of babies like the infantile colic. | Children were divided into three subgroups and were given the Chiropractic Manual Therapy sessions. Followed by monitoring. For this study, the infants which are having unexplained persistent crying problems are included at the chiropractic teaching clinic in the UK. Infants which are of 8 weeks are involved in the study. | The crying time was reduced. The number of children who are treated completed is three whereas there are some infants which are under the treatment. | It is an effective approach to curing the infant colic |
Salvatore (2016) | To present a pharmacological approach to dealing with Functional gastrointestinal disorders (FGIDs) in infancy and early childhood. | The research is based on the revaluation of secondary data from electronic data records and databases. The relevant literature was also reviewed. | No definite evidence was found in the explanation of therapeutic approaches to deal with the Functional gastrointestinal disorders (FGIDs) | Some medicines are suggested to cure Functional gastrointestinal disorders (FGIDs), but the results are o to be dependent on the cases, respectively. |
Sheidaei (2016) | To evaluate the proficiency of massage therapy in curing the infant colic, an RCT approach. | The massage was given to the selected colic infants for about twenty minutes, and the RCT group was rocked gently for the observed same interval, roughly, before sleep time. | The massage therapy resulted in ease in sleep and a decrease in crying time. | Massage therapy shows the best results in treating colic infants in the domain of manual therapies. |
Steel (2017) | The research is dedicated to analyzing the role of osteopathy in manual treatments of medical complications | The structure of the study includes the evaluation of the performance of healthcare players in the field of providing medical assistance to the public. | The research has declared that the conduct of mania treatment, osteopathy has been the foremost technique of curing complications in the majority of countries across. | Through osteopathy, medical therapeutic interventions have become safer and easier to conduct. It is analyzed that by massaging properly, people can improve their colic symptoms in the period of one week of intervention for every outcome. There are major differences are observed among the intervention as well as control groups favoring the massaging therefore this therapy is regarded to be effective as compared to rocking for the infants having colic symptoms. |
Question | Y, N, ? na | Comment |
1. Is the study population clearly defined with clear inclusion and exclusion criteria? | N | What is the study population? |
2. Is the sample representative of the population? The best samples are taken at random from the whole population but sometimes modifications of random sampling are used (these include stratified sampling, cluster sampling, or multistage sampling). Nonrandom sampling techniques may be used but these are less representative of the population (e.g. volunteers, purposive sampling, snowball sampling, incidental/convenience sampling, quota sampling, etc). small nonrandom samples are particularly unrepresentative. Are alternatives to random sampling explained and justified? | N | Note how the sample was taken |
Question | Y, N, ? na | Comment |
1. Is the study population clearly defined with clear inclusion and exclusion criteria? | N | What is the study population? |
2. Is the sample representative of the population? The best samples are taken at random from the whole population but sometimes modifications of random sampling are used (these include stratified sampling, cluster sampling, or multistage sampling). Nonrandom sampling techniques may be used but these are less representative of the population (e.g. volunteers, purposive sampling, snowball sampling, incidental/convenience sampling, quota sampling, etc). small nonrandom samples are particularly unrepresentative. Are alternatives to random sampling explained and justified? | N | Note how the sample was taken |
3. Is a power calculation performed to determine sample size?
| N |
|
4. Are the sample participants randomly allocated to the intervention and control groups? Random allocation is where those in the selected sample are given an equal chance of being assigned to test groups (either the treatment group or the control). Makes sure that the mix of participants for treatment and control are similar (age, gender, ethnicity). This makes the comparison fair. Ensures that when results are compared at the end then differences are due to the intervention and not pre-existing differences in the population.
| N | Outline the method of allocation to groups. |
5. Did the paper use nonparametric or parametric statistics? Non –Parametric Statistics include median, mode, quartiles, inter-quartile range, Wilcoxen test, Mann Whitney U test, Spearman’s Rank Correlation Coefficient, etc Parametric Statistics include Mean, Standard Deviation, Confidence Intervals t-test (paired and unpaired), Pearson’s Correlation Coefficient, etc | N | Note the descriptive statistics used.
Note the inferential statistics used. |
6. Is the choice of statistics appropriate? First, decide if parametric or nonparametric tests should be used. Then decide which test is appropriate. | N | Comment on the appropriateness |
7. If appropriate, do the researchers justify their use of unusual statistics? | N |
|
8. Is the null hypothesis clear (either stated or implied)
| N |
|
9. Are there any significant differences between the groups at the beginning of the trial? | N | If there are significant differences, what are they and how might they have affected the outcomes (i.e. acted as confounding factors)?
|
10. Are all participants who started the study accounted for? Participants withdraw after the start of a trial for a variety of reasons which may include adverse reactions, loss of motivation, clinical reasons, personal reasons, etc. Withdrawal can bias the results. Reasons for withdrawal should be recorded. | N | Is there a consort diagram to show the flow of participants at each stage of the trial? If no flow diagram, note if the paper records withdrawals (dropouts) and nonresponders, etc. Note how many dropouts/nonresponders
|
11. Is it clear how withdrawals and non-responders were kept to a minimum?
| N |
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12. Are results analyzed on an ‘intention to treat basis’ i.e. people who start the trial and withdraw are included in the analysis. There is no consensus on how to analyze on an ‘intention to treat basis’ and analyses have different drawbacks.
| N | If appropriate, note the method used for intention to treat analysis. What do you see as the drawbacks of the method used? |
13. Is it clear how outliers were analyzed? | Y |
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14. Are the data normally distributed? | N | Outline how data were tested for normal distribution by the researchers?
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15. Are ‘p’ values stated? The lower the p-value the less likely it is that the difference happened by chance, so the higher the significance of the finding. A p-value of 0.05 and smaller is used to decide if results are statistically significant and unlikely to have occurred by chance | N |
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16. Are the statistics interpreted correctly?
| N |
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17. Are the limitations of the statistics discussed e.g. small sample size, dropouts, etc?
Remember, small nonrandom samples may be unrepresentative of the population so differences found between intervention and control groups might not be found in the population. | N |
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18. Is statistical significance discussed as clinical significance? | N |
|
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