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Trusting systematic reviews and meta-analyses: all that glitters is not gold!
  1. Adam Weir,
  2. Safia Rabia,
  3. Clare Ardern
  1. Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
  1. Correspondence to Dr Adam Weir, Aspetar Orthopaedic and Sports Medicine Hospital, PO Box 29222, Doha, Qatar;{at}

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Systematic reviews provide Level 1 evidence. They are firmly part of modern medical practice. Ideally, systematic reviews provide readers with comprehensive evidence summaries and can highlight research deficiencies. Busy clinicians welcome bite sized summaries to inform their practice. As part of BJSM’s Education theme, we address the question ‘Should I trust this systematic review?’.

Systematic reviews are only as good as the papers they contain

Meta-analysis is the highest level of evidence, but the quality of any systematic review or meta-analysis is only as good as the studies identified and included. Summarising papers with a high risk of bias does not eliminate this bias. Pooling data (meta-analysis) from papers with a high risk of bias actually compounds the bias.1 These basic facts are often underappreciated and overlooked.

Systematically reviewing systematic reviews

Systematic reviews in sports medicine and sports physiotherapy are at once a cause for celebration and concern. Celebration—as scientific evidence supports many treatments in our young profession. Concern—because there are some important weaknesses in our field. The conclusions of more than half of the 200 clinical sports medicine systematic reviews, published between 2009 and 2013, in five major orthopaedic journals (note, not …

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  • Twitter Follow Clare Ardern at @clare_ardern

  • Contributors All the authors were responsible for the study design. AW and CA reviewed the 10 articles using AMSTAR. The results were collated by SR. All the authors approved the final draft.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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