The evidence included in the systematic review was primarily based on randomised controlled trials. The quality of all included systematic reviews and randomised controlled trials was considered to be moderate to high.
Thirty-five randomised controlled trials were included in the systematic review for the primary research questions:
- Each of the included trials was considered to be of moderate to high quality.
- The trials were all randomised, though some trials did not describe randomisation method. In trials that did specify method of randomisation, methods were considered high quality.
- The trials were either open label or blinding was not stated, with only GOG218 identified as double blind.
- Survival outcomes by intention-to-treat analysis were reported by the majority of trials.
- All trials had standardised assessment of outcomes and almost every trial had well matched population characteristics between treatment arms at baseline.
- Most of the phase III trials were powered to detect a significant difference in primary outcomes.
Ten studies that were not randomised controlled trials were included for the research question assessing subgroups. As the papers included in this section had a range of study designs, formal quality assessment was not performed.
Nine studies that were not randomised controlled trials were included for the research question addressing specific chemotherapy requirements for women with epithelial ovarian cancer who are obese. These studies did not compare different doses or schedules of chemotherapy among obese patients.
Six Cochrane reviews were included in the systematic review. These were considered to be of high quality.