Systematic Reviews: The Good, the Bad and the Ugly
- 5 May 2009
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in The American Journal of Gastroenterology
- Vol. 104 (5), 1086-1092
- https://doi.org/10.1038/ajg.2009.118
Abstract
Systematic reviews systematically evaluate and summarize current knowledge and have many advantages over narrative reviews. Meta-analyses provide a more reliable and enhanced precision of effect estimate than do individual studies. Systematic reviews are invaluable for defining the methods used in subsequent studies, but, as retrospective research projects, they are subject to bias. Rigorous research methods are essential, and the quality depends on the extent to which scientific review methods are used. Systematic reviews can be misleading, unhelpful, or even harmful when data are inappropriately handled; meta-analyses can be misused when the difference between a patient seen in the clinic and those included in the meta-analysis is not considered. Furthermore, systematic reviews cannot answer all clinically relevant questions, and their conclusions may be difficult to incorporate into practice. They should be reviewed on an ongoing basis. As clinicians, we need proper methodological training to perform good systematic reviews and must ask the appropriate questions before we can properly interpret such a review and apply its conclusions to our patients. This paper aims to assist in the reading of a systematic review.Keywords
This publication has 48 references indexed in Scilit:
- Meta-analysis in medical research: Potentials and limitationsUrologic Oncology: Seminars and Original Investigations, 2008
- Meta-analysis: Sequential Therapy Appears Superior to Standard Therapy for Helicobacter pylori Infection in Patients Naive to TreatmentAnnals of Internal Medicine, 2008
- Non-steroidal anti-inflammatory drugs and myocardial infarctions: comparative systematic review of evidence from observational studies and randomised controlled trialsAnnals Of The Rheumatic Diseases, 2007
- Evidence‐based sample size calculations based upon updated meta‐analysisStatistics in Medicine, 2007
- What is the optimal length of proton pump inhibitor-based triple therapies for H. pylori ? A cost-effectiveness analysisAlimentary Pharmacology & Therapeutics, 2001
- Using evidence from different sources: an example using paracetamol 1000 mg plus codeine 60 mgBMC Medical Research Methodology, 2001
- Meta-analysis: Principles and proceduresBMJ, 1997
- Systematic Reviews: Synthesis of Best Evidence for Clinical DecisionsAnnals of Internal Medicine, 1997
- Evidence based medicine: what it is and what it isn'tBMJ, 1996
- Cost-effectiveness of Helicobacter pylori eradication for the long-term management of duodenal ulcer in CanadaArchives of Internal Medicine, 1995