Should all systematic reviews be at the top of the pyramid?​

By Honório HM1​

Date: 01/2017
Journal: Arch Oral Biol

Summary :

  • Cochrane conceived the basic concept of systematic reviews and is now considered one of the pioneers and founders of evidence-based medicine.​
  • The systematic review incipiently recommended by Cochrane in 1972 has undergone many changes and improvements in the last four decades.​
  • Cochrane Collaboration ( has a role in orienting, preparing and maintaining systematic reviews.​
  • The first point that should guide a systematic review is always the key question (PICO Strategy).​
  • Then, at the heart of a systematic review is its search strategy, which represents 80% of the quality level of a study.​
  • Large databases such as PubMed, EMBASE and Science Direct can be used in the search for scientific evidence on a particular subject.​
  • After data search and later inclusion of articles based on the eligibility criteria, articles should be evaluated for their quality.​
  • Another factor that often is neglected by authors of systematic reviews is the influence of data heterogeneity, both in statistical analysis and in the discussion of the work.​
  • To answer the question .. many systematic reviews should not be ranked at the top of the scientific evidence pyramid. ​
  • The reason is that many basic precautions are often not taken, generating systematic reviews with a less than satisfactory level of scientific evidence about the subject being studied. ​