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May 1, 2009The American Journal of Gastroenterology170 citations

Systematic Reviews: The Good, the Bad and the Ugly

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YYYuhong YuanRHRichard H. Hunt

Key Points

  • The aim is to assess the advantages and disadvantages of systematic reviews and to highlight the importance of methodological rigor.
  • Systematic evaluation of existing literature on systematic reviews and meta-analyses.
  • Analysis of factors leading to bias in systematic reviews.
  • Discussion of proper methodological training for clinicians.
  • Systematic reviews enhance precision of effect estimates compared to individual studies.
  • Inappropriate data handling in systematic reviews can lead to misleading conclusions.
  • Clinicians require proper methodological training to effectively interpret and utilize systematic reviews.

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.

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Cite This Study

Yuan et al. (2009) studied this question.

synapsesocial.com/papers/69df1aebb8d7e94566614910https://doi.org/10.1038/ajg.2009.118
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