Table 3: Results of Risk of bias evaluation.
| Author & Publication year | Random sequence generation (selection bias) | Allocation concealment (selection bias) | Blinding (performance bias and detection bias) All outcomes | Incomplete outcome data (attrition bias) All outcomes | Selective reporting (reporting bias) | Overall risk of bias |
| Drory, et al., 2001 | Low risk - The institution statistician performed the randomization using computer software | Unclear risk - not reported | Unclear risk - blinding not reported | High risk - Both groups lost a lot of people- reasons for drop outs not reported - numbers are | Low risk - All outcomes reported | Unclear risk |
| Dal Bello-Haas, et al., 2007 | Low risk - random sequence reported | Low risk - Opaque envelopes with group allocation used; note that participants were not blind to group allocation and some revealed their allocation to therapist collecting data | Low risk - Participants completing intervention were unblinded; outcome evaluators were blinded to group allocation | Low risk - Participants were lost to follow up in both groups- reasons clearly stated and missing data were imputed for analyses | Low risk - All outcomes reported | Low risk |
| Creemers, et al., 2013 | Low risk - All ALS teams were invited to participate; teams were matched | Low risk - Allocation concealment was at the cluster level | Low risk - blinded outcome evaluators at all follow-up times | Low risk - Although they lost quite a few participants from both groups, the losses are explained and many were because of death | Low risk - All outcomes reported | Low risk |
| Jensen, et al., 2005 Note: Data presented does not clearly identify people with ALS | Low risk - People with neurodegenerative conditions were allowed to complete the survey | Low risk - Limited restrictions on who could participate on the survey | Low risk - No outcomes based on performance, all self-report measures | Low risk - Onetime survey therefore no attrition | Low risk - data on all outcomes reported | Low risk |
| Korner, et al., 2013 | Low risk - Participant selection mentioned | Low risk - Groups assigned based on allocation | Low risk - all outcome measures are self-report | Low risk - data collected when patients visited the clinic post-intervention | Unclear risk - Can’t identify dependent and independent variables in regression | Low risk |
| Van den Berg, et al., 2005 | Unclear risk - No random selection and not clear how patients were recruited or selected | Unclear risk - not clear how allocations were determined | Low risk - nurses collecting outcome data blinded to treatment group | Unclear risk - no clear description of dropouts nor if patients were followed over time | Low risk - all outcome measures reported | Unclear risk |