Systematic Reviews and Meta-analyses in Transplantation: Challenges and Pitfalls?

Decision making in transplantation is complex, dynamic, and often made under the context of uncertainties. In the case of diagnostic uncertainties, symptoms can be indistinct, with overlap between many different conditions. Even if the correct diagnoses are known, treatment strategies for the same condition may vary and are largely dependent on clinicians' preference and personal experiences. Systematic reviews and meta-analyses challenge the conventional role of the experts and their perceptions and rely, instead, on the best available evidence to guide clinical decision making. Through careful searching and closely examining, appraising, and synthesizing all available evidence, systematic reviews and meta-analyses provide the necessary and relevant information to better inform healthcare management and policy making by highlighting evidence that is pertinent to decisions. This commentary provides an overview of the concepts and methods used in systematic review, highlighting the potential capability of these methods in transplantation and how they may facilitate clinical decision making in transplantation.