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‘More research is needed’ is a most unhelpful conclusion for the clinician reader of a systematic review. Clinicians look to researchers for the ‘research evidence’ part of Professor Sackett’s ‘three circles’ of evidence-based practice.1 The clinician can not ignore the patient in front of him or her just because there is no evidence from systematic reviews or randomised controlled trials (RCTs): ‘Kindly forget about your shoulder problem, until we have better research to tell me what to do’? This will not do! In this editorial, we share three practical tips for authors synthesising lower level evidence in systematic reviews, when high-quality RCTs are absent. Our goal is to help authors help clinicians help patients.
Consider the patient who plays tennis and presents with shoulder pain. Right now, the clinician who is seeking RCT evidence on how to progress from impairment-focused tasks in neutral shoulder positions to high-level, sport-specific tasks will be disappointed. Being able to function in shoulder elevation positions above …
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