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As clinicians and academics, we are challenged to sift through a myriad of publications with the key goal and purpose of assessing whether the quality of the data and research is good enough to have an impact on the way we practice and on our responsibility to optimise the care of our patients.1–6 Various categorisations of the quality of evidence are available with one of the classics being level of evidence 1 used for high-quality randomised control trials, level of evidence 2 for prospective cohort studies, level of evidence 3 for cohort studies, level of evidence 4 for descriptive case series, and level of evidence 5 for ‘expert’ opinion.
For some, systematic reviews and meta-analyses have taken a pre-eminent place in the hierarchy of evidence superseding even a high-quality, well-targeted, randomised control trial. However, one must bear in mind that the weak link of any systematic review/meta-analysis is the fact that the authors may not have performed …
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