The rationale behind systematic reviews in clinical medicine: a conceptual framework


A systematic review (SR) is a type of review that uses a systematic method to provide a valid summary of existing literature addressing a clear and specific question. In clinical medicine (CM), the concept of SR is well recognized, especially after the introduction of evidence-based medicine; The SR of randomized clinical trials (RCTs) is considered the highest level of evidence on therapeutic effectiveness. Despite the popularity of the SRs and the increasing publication rate of SRs in CM and other healthcare literature, the concept has raised criticisms. Many of proper criticisms can be due to the deviation of some existing SRs from the original philosophy and well-established rationale behind the concept of SR. On the other hand, many criticisms are misconceptions about SRs which still exist even several decades after introducing the concept. This article presents a conceptual framework for clarifying the rationale behind SR in CM by providing the relevant concepts and their inter-relations, explaining how methodological standards of an SR and its rationale are connected, and discussing the rationale under the three-section: SR as a type of synthetic research, SR as a more informed and less biased review, and SR as an efficient scientific tool.

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This article is a part of Dr. Hamideh Moosapour’s Ph.D. thesis entitled “Theoretical Challenges in Conceptualization of Evidence-Based Islamic Biomedical Ethics: A Comparative Study in Philosophy of Medicine and Medical Ethics”. The project was funded by Evidence Based Medicine Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences.

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HM had substantial contributions to concept and design, drafting, writing, and revising the manuscript critically for important intellectual content and approving the final version to be published. FS had substantial contributions to drafting, writing, and revising the manuscript and approving the final version to be published. MA had contributions to drafting the manuscript and approving the final version to be published. AS had contributions to concept and design, revising the manuscript critically for important intellectual content, and approving the final version to be published. BL had contributions to concept and design, revising the manuscript critically for important intellectual content, and approving the final version to be published.

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Correspondence to Akbar Soltani or Bagher Larijani.

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Moosapour, H., Saeidifard, F., Aalaa, M. et al. The rationale behind systematic reviews in clinical medicine: a conceptual framework. J Diabetes Metab Disord (2021).

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  • Systematic review
  • Meta-analysis
  • Rationale
  • Evidence based medicine
  • Synthetic research
  • Conceptual Framework