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Neurodevelopmental data among infants treated for ROP are limited. In the hierarchy of evidence, a meta-analysis may potentially provide higher quality evidence than a single study, and we
commend Kaushal et al. for undertaking this important step. A major limitation of pooled data, however, is that results depend upon the quality and size of included studies.
In a meta-analysis, assessing the risk of bias is paramount. The authors used the Modified Newcastle–Ottawa Scale, which, although a convenient assessment of non-randomized studies for risk
of bias, does not remove bias. Inclusion of bias in a meta-analysis does not resolve uncertainty but propagates the bias.
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