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How objective are systematic reviews? Differences between reviews on complementary medicine.

Klaus Linde1, Stefan N Willich

  • 1Centre for Complementary Medicine Research, Department of Internal Medicine II, Technische Universität, Kaiserstrasse 9, 80801 München, Germany. Klaus.Linde@lrz.tu-muenchen.de

Journal of the Royal Society of Medicine
|January 10, 2003
PubMed
Summary

Systematic reviews on complementary medicine can yield different conclusions. Minor methodological variations, such as differing inclusion criteria, significantly impact review outcomes and findings.

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Area of Science:

  • Integrative and Complementary Medicine
  • Evidence Synthesis
  • Scientific Methodology

Background:

  • Systematic reviews are crucial for summarizing medical evidence.
  • Previous research suggests potential variability in systematic review outcomes.

Purpose of the Study:

  • To assess the consistency of systematic reviews addressing the same research questions.
  • To identify factors contributing to discrepancies in systematic review findings across complementary medicine modalities.

Main Methods:

  • Qualitative comparison of systematic reviews on herbal medicine, homeopathy, and acupuncture.
  • Analysis of key methodological components: literature searching, inclusion criteria, data extraction, and quality assessment.
  • Examination of results and conclusions across multiple reviews on identical topics.

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Main Results:

  • Significant discrepancies were observed in systematic reviews across herbal medicine, homeopathy, and acupuncture.
  • Different inclusion criteria were a primary driver of variability in thirteen topics.
  • Variations in literature searching, quality assessment, and data synthesis methods also contributed to divergent results and conclusions.

Conclusions:

  • Systematic reviews, even on the same topic, can produce substantially different outcomes.
  • Methodological choices in systematic reviews, particularly inclusion criteria, profoundly influence findings.
  • Readers must exercise caution, recognizing that minor review process decisions can lead to major impacts on synthesized evidence.