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however, overcome many of the problems associated with relying solely on published data and some of the problems associated with relying on aggregate data and will add to the analyses that can be performed.It might therefore provide the "gold standard" to which systematic reviews should strive."Which steps in the process are the most important for improving reliability requires further testing and evidence, especially if some of these steps lengthen the time needed to conduct the meta-analysis but do not greatly improve its reliability.To this end, some of the topics for consideration would be the use of trials from which individual patient data are not available but published data are and of trials in which the individual patient data reveal problems (such as the inappropriate exclusion of some patients and the subsequent des- truction of their relevant records) that cannot be rectified.Just as different forms of health care need to be reliably assessed, so the techniques for reviewing evidence from randomised controlled trials should be empirically investigated.