Study designs of evaluations included in the review
Parallel or crossover randomised controlled trials (RCTs) were eligible for inclusion if they reported adequate allocation concealment, blinding of the patients and investigators, and use of intention-to-treat analysis. Crossover studies had to report non significant carry-over effects or data from the first treatment period.
Specific interventions included in the review
Studies were eligible if they compared rapid rTMS with sham treatment applied with the coil angled between 45 and 90 degrees from the scalp. Rapid rTMS involved frequencies of 10 Hz or more, applied over the left dorsal prefrontal cortex (DLPFC) at an intensity of at least 80%, and was given over 5 to 10 days. Studies that used rTMS combined with starting a medication were excluded. The included studies used different frequencies, intensities, duration of train of pulses and days of treatment of rTMS.
Participants included in the review
Studies of adults with a major depressive episode diagnosed using the American Psychiatric Association's DSM-IV criteria were eligible for inclusion.
Outcomes assessed in the review
Studies that measured outcomes using the 21-item Hamilton Rating Scale for Depression and reported data suitable for inclusion in a meta-analysis (including post-treatment means with standard deviations) were eligible for inclusion.
How were decisions on the relevance of primary studies made?
The author did not state how the studies were selected for the review, or how many reviewers performed the selection.