Surgical systematic reviews: best available evidence or disposable waste?

Evidence-based medicine demands treatment options for patients to be based on the current best available evidence. Systematic reviews (SRs) with meta-analyses allow surgeons to make therapeutical decisions in accordance with the highest level of evidence. Also, high-quality SRs support physicians to challenge the colossal amount of new research data created daily. The systematic review working group of the Study Center of the German Society of Surgery (SDGC) has created specific methodological literature regarding surgical SRs, giving recommendations to assess critical risk of bias and to prevent the creation of SRs that do not provide any new insights to the field. SRs should only be considered if there is new clinically relevant data available that allows the SR to create novel evidence. To address the dilemma of new SRs generated without adding new evidence, living systematic reviews and evidence mapping represent an innovative approach, in which SRs are regularly updated with new research data.