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The pitfalls of conventional methods of screening for systematic reviews: Lessons learned
Mohammad Mahdi Bagheri Asl1, Alejandro M Spiotta2
1Department of Neurosurgery, Medical University of South Carolina, Charleston, South Carolina, USA.
The American Journal of the Medical Sciences
|March 16, 2026
Summary
Selective reporting in Systematic Review and Meta-Analyses (SRMAs) causes bias. This study proposes solutions to make all findings, including nonsignificant outcomes, searchable to improve evidence quality.
Area of Science:
- Medical research methodology
- Evidence-based medicine
Background:
- Systematic Review and Meta-Analyses (SRMAs) are high-level evidence but susceptible to bias.
- Nonsignificant or secondary outcomes are often omitted from abstracts, creating a "file drawer problem".
Purpose of the Study:
- To address the inaccessibility of nonsignificant outcomes in SRMAs.
- To propose recommendations for improving the discoverability of all study findings.
Main Methods:
- Recommendations developed for primary study researchers, secondary study researchers, and journals/databases.
- Focus on enhancing database searchability for full-text findings.
Main Results:
- Selective reporting leads to overestimated treatment effects and biased complication rates in SRMAs.
- Current academic databases do not index full-text content, hindering access to unpublished or omitted findings.
Conclusions:
- Collaborative stakeholder efforts are needed to improve accessibility of nonsignificant outcomes.
- Enhanced searchability of all findings will reduce bias in evidence synthesis and inform clinical guidelines.
- Addressing this issue is crucial for accurate patient care and reliable clinical decision-making.
Keywords:
BibliographicDatabasesEvidence-based medicineGray literatureMeta-analysis as topicMetadataPublication biasSearch engineSystematic reviews as topicMore Related Videos
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