Systematic Reviews: Critical Links in the Great Chain of Evidence

Editorials1 March 1997Systematic Reviews: Critical Links in the Great Chain of EvidenceCynthia D. Mulrow, MD, MSc, Deborah J. Cook, MD, MSc, and Frank Davidoff, MD, EditorCynthia D. Mulrow, MD, MScAudie L. Murphy Memorial Veterans Hospital, San Antonio, TX 78284St. Joseph's Hospital, Hamilton, Ontario L8N 4A6, Canada Annals of Internal Medicine, Philadelphia, PA 19106, Deborah J. Cook, MD, MScAudie L. Murphy Memorial Veterans Hospital, San Antonio, TX 78284St. Joseph's Hospital, Hamilton, Ontario L8N 4A6, Canada Annals of Internal Medicine, Philadelphia, PA 19106, and Frank Davidoff, MD, EditorAudie L. Murphy Memorial Veterans Hospital, San Antonio, TX 78284St. Joseph's Hospital, Hamilton, Ontario L8N 4A6, Canada Annals of Internal Medicine, Philadelphia, PA 19106Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-126-5-199703010-00008 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Successful clinical decisions, like most human decisions, are complex creatures [1]. In making them, we draw on information from many sources: primary data and patient preferences, our own clinical and personal experience, external rules and constraints, and scientific evidence (Figure 1). The mix of inputs to clinical decisions varies from moment to moment and from day to day, depending on the decision and the decision makers. In general, however, the proportion of scientific evidence in the mix has grown progressively over the past 150 years or so.Figure 1.Factors that enter into clinical decisions.Figure 1. Factors that enter into clinical ...References1. Damasio AR. Descartes' Error: Emotion, Reason, and the Human Brain. New York: GP Putnam; 1994. Google Scholar2. Hart PD. Early controlled clinical trials [Letter]. BMJ. 1996; 312:378-9. Google Scholar3. The Cochrane Collaboration. The Cochrane Library. Oxford, United Kingdom: Update Software; 1996 [updated quarterly]. Google Scholar4. Bero L, Rennie D. The Cochrane Collaboration. Preparing, maintaining, and disseminating systematic reviews of the effects of health care. JAMA. 1995; 274:1935-8. Google Scholar5. Mulrow CD. The medical review article: state of the science. Ann Intern Med. 1987; 106:485-8. Google Scholar6. Mulrow CD. Rationale for systematic reviews. In: Chalmers I, Altman DG, eds. Systematic Reviews. London: BMJ; 1995:1-8. Google Scholar7. Chalmers I, Altman DG, eds. Systematic Reviews. London: BMJ; 1995. Google Scholar8. Cook DJ, Mulrow CD, Haynes RB. Systematic reviews: synthesis of best evidence for clinical decisions. Ann Intern Med. 1997; 126:376-80. Google Scholar9. Begg C, Cho M, Eastwood S, Horton R, Moher D, Olkin I, et al. Improving the quality of reporting of randomized, controlled trials. The CONSORT statement. JAMA. 1996; 276:637-9. Google Scholar10. Moher D, Olkin I. Meta-analysis of randomized, controlled trials. A concern for standards. JAMA. 1995; 274:1962-3. Google Scholar11. Naylor CD. Grey zones of clinical practice: some limits to evidence-based medicine. Lancet. 1995; 345:840-2. Google Scholar Author, Article, and Disclosure InformationAuthors: Cynthia D. Mulrow, MD, MSc; Deborah J. Cook, MD, MSc; Frank Davidoff, MD, EditorAffiliations: Audie L. Murphy Memorial Veterans Hospital, San Antonio, TX 78284St. Joseph's Hospital, Hamilton, Ontario L8N 4A6, Canada Annals of Internal Medicine, Philadelphia, PA 19106Corresponding Author: Cynthia D. Mulrow, MD, MSc, Audie L. Murphy Veterans Memorial Hospital, 7400 Merton Minter Boulevard, San Antonio, TX 78284.Current Author Addresses: Dr. Mulrow: Audie L. Murphy Veterans Memorial Hospital, 7400 Merton Minter Boulevard, San Antonio, TX 78284. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoSystematic Reviews: Synthesis of Best Evidence for Clinical Decisions Deborah J. Cook , Cynthia D. Mulrow , and R. Brian Haynes Metrics Cited byApplying bibliometric review methods in education: rationale, definitions, analytical techniques, and illustrationsAssessment of spin in abstracts of Endodontic Systematic Reviews with meta‐analyses published between 2010 and 2022. 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Evidence-based medicine: A passing fancy or the future of primary care?Broadening the Evidence Base for Evidence-Based GuidelinesThe Role of Information Technology in Disease Management: Supporting Identification and Delivery of Best PracticesShould alpha-interferon be included as standard treatment in multiple myeloma? 1 March 1997Volume 126, Issue 5Page: 389-391KeywordsClinical trialsDecision makingHealth careHospital medicineInformation storage and retrievalInformation technologyMolecular biologyResearch laboratoriesResearch reporting guidelinesSystematic reviews ePublished: 15 August 2000 Issue Published: 1 March 1997 Copyright & PermissionsCopyright © 1997 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...