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Reviews which limit the literature search to published studies risk
misrepresenting the evidence, given that studies which report significant
results are published faster and cited more often. Reviews which do not
practice duplicate data extraction - where two people do this independently of
one another - run the risk of distorting the evidence, because single data
extraction leads to more inaccuracies and omissions. Choosing narrative
synthesis over meta-analysis is also found to give less accurate results.
In each case, there is a tendency to present conclusions that are more positive
than the evidence warrants. Traditionally, it has been hard to explain to
funders that the complexity of the review process is necessary, and that a
high-quality review involves both time and resources. This made it all the more
heartening to hear in Dhaka that policymakers are increasingly aware of this
problem. Representatives of the UK's development agency stated that
DFID had decided not to compromise on quality. The challenge now is to ensure
that more genuinely systematic reviews are conducted and completed. How about
that for a New Year's Resolution?
Eamonn Noonan, CEO