Reviews the assessments, in medical systematic reviews, of 'Quality of Evidence'.
Please note, this research does not attempt to assess the Quality of Evidence itself, just what is said about it in those studies that attempt to assess it (as, for example, in the current NICE exercise around low back pain and sciatica - though that exercise is not considered in this research).
In passing it notes the absense of any measure of Quality of Evidence in a significant number (34) of the 76 systematiic reviews that met the broader critieria of the study (which was recent publication in the most prestigious medical journals). The analysis was stratified by type of intervention eg drugs, devices, psychosocial.
The results were not encouraging for the current soundness of Evidence Based Medicine: 'try harder' is the main message.
Results and conclusions reported in the abstract were:
Among 76 systematic reviews, QOE ratings were available for only 42, netting 1472 comparisons. Of these, 57% included observational studies; 4% were rated as high and 12% as moderate; the rest were low or insufficient. The ratings varied by topic: 74% of the surgical study pairs were rated as low or insufficient, compared with 82% of pharmaceuticals and 86% of device studies, 88% of organisational, 91% of lifestyle studies, and 94% of psychosocial interventions.
Conclusions We are some distance from being able to claim evidence-based practice. The press for individual-level data will make this challenge even harder.