Abstract
The low quality of included trials, insufficient rigour in review methodology, ignorance of key pain issues, small size, and over-optimistic judgements about the direction and magnitude of treatment effects all devalue systematic reviews, supposedly the ‘gold standard’ of evidence. Available evidence indicates that almost all systematic reviews in the published literature contain fatal flaws likely to make their conclusions incorrect and misleading. Only 3 in every 100 systematic reviews are deemed to have adequate methods and be clinically useful. Examples of research waste and questionable ethical standards abound: most trials have little hope of providing useful results, and systematic review of hopeless trials inspires no confidence. We argue that results of most systematic reviews should be dismissed. Forensically critical systematic reviews are essential tools to improve the quality of trials and should be encouraged and protected.
| Original language | English |
|---|---|
| Pages (from-to) | 557-566 |
| Number of pages | 10 |
| Journal | European Journal of Pain |
| Volume | 26 |
| Issue number | 3 |
| Early online date | 8 Jan 2022 |
| DOIs | |
| Publication status | Published - 31 Mar 2022 |
Bibliographical note
Funding Information:No funding was received for this work. The authors are grateful to Professor Luis Garcia-Larrea for his guidance in the development of the manuscript, and to Professor David Gavaghan for help with simulations.