Maarten van Egmond

106 Chapter 5 Figure 2. Forest plot of telerehabilitation interventions versus usual care with quality of life outcomes Meta-analysis of standardized mean difference comparing QoL of participants receiving an intervention with telerehabilitation with control patients receiving usual care. The left side of the Forest plot indicates higher QoL levels in favor of the control intervention; the right side of the Forest plot indicates higher QoL levels in favor of the telerehabilitation intervention. Participants undergoing the telerehabilitation intervention demonstrated significantly higher levels in QoL compared with usual care. Methodological quality of included studies Standards of reporting varied considerably between studies. Random sequence generation was performed in 14 studies 8,24,25,28-30,32-37,40,44 and was lacking in two studies. 16,42 Allocation concealment appeared to be unclear in 10 studies 8,25-28,32,36,38,40,41 , and selection bias could be present in three studies. 16,42,43 The majority of studies reported on blinding of outcome assessment, suggesting a low risk of detection bias. Incomplete outcome data were detected in seven studies 8,25,33,35,37,38,43 and were unclear in another seven studies 24,26,27,34,39,42,44 , suggesting attrition bias. Selective reporting appeared to be present in four studies 16,35,37,44 , which may have induced reporting bias. Other biases were not found between studies. A risk of bias summary and full details of individual studies can be found in Figures A and B (see online supplementary material).