There was no significant difference in relation to the resolution of fever , abscess size , and hospital stay .
The beneficial effects of PA were seen with medium-to-large ( > 5 cm ) ALA and not with small ( < 5 cm ) ALA .
Percutaneous aspiration as compared with metronidazole alone results in the early resolution of pain and tenderness in patients with medium-to-large ALA .
Percutaneous catheter drainage is better for larger ALA .
The role of metronidazole alone , percutaneous aspiration ( PA ) , and percutaneous catheter drainage ( PCD ) in the treatment of uncomplicated amebic liver abscess ( ALA ) is still unclear .
This systematic review and meta- analysis evaluated the available evidence s with regard to treatment modalities in such patients .
Randomized clinical trials in HEPATOLOGY: predictors of quality.
Evidence shows that the quality of r and omized clinical trials ( RCTs ) affects estimates of intervention efficacy , which is significantly exaggerated in low- quality trials . The present study examines the quality of all 235 RCTs published in HEPATOLOGY from the initiation in 1981 through August 1998 .  Quality was assessed by means of a vali date d 5-point scale and separate quality components associated with empirical evidence of bias . Only 26 % of all RCTs reported sample size calculations , 52 % adequate generation of the allocation sequence , 34 % adequate allocation concealment and 34 % double-blinding . The median quality score of all trials was 3 points ( range , 1 - 5 points ) . Multiple logistic regression analysis explored the association between quality and therapeutic areas , number of centers , external funding , year of publication , and country of origin . High- quality trials were most likely to investigate portal hypertension ( odds ratio [ OR ] : 2.4 ; 95 % CI : 1.1 - 5.5 ; P = .03 ) , be multicentered ( OR : 3.4 ; 95 % CI : 1.3 - 8.9 ; P = .01 ) , sponsored by public organizations ( OR : 4.2 ; 95 % CI : 2.1 - 8.6 ; P = .0001 ) , or the drug and device industry ( OR : 4.7 ; 95 % CI : 2.2 - 10.2 ; P = .0001 ) compared with other therapeutic areas , single-center trials , and trials with no external funding . Quality did not improve with time and was not associated with country of origin . The main conclusions are that the quality of RCTs in HEPATOLOGY needs improvement and that the probability of high quality increased with the number of centers involved and external funding
There was no significant difference in relation to the resolution of fever , abscess size , and hospital stay .
The beneficial effects of PA were seen with medium-to-large ( > 5 cm ) ALA and not with small ( < 5 cm ) ALA .
Percutaneous aspiration as compared with metronidazole alone results in the early resolution of pain and tenderness in patients with medium-to-large ALA .
Percutaneous catheter drainage is better for larger ALA .
The role of metronidazole alone , percutaneous aspiration ( PA ) , and percutaneous catheter drainage ( PCD ) in the treatment of uncomplicated amebic liver abscess ( ALA ) is still unclear .
This systematic review and meta- analysis evaluated the available evidence s with regard to treatment modalities in such patients .