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Michael Bigby, MD; Hywel Williams, MSc, PhD, FRCP

Arch Dermatol. 2003;139:795-798.

A systematic review is an overview that answers a specific clinical question and contains a thorough, unbiased search of the relevant literature, explicit criteria for assessing studies, and a structured presentation of the results. Many systematic reviews incorporate a meta-analysis, ie, a quantitative pooling of several similar studies to produce an overall summary of treatment effect.^1-2 Meta-analysis provides an objective and quantitative summary of evidence that is amenable to statistical analysis,¹ and it allows recognition of important treatment effects by combining the results of small trials that individually might have lacked the power to consistently demonstrate differences among treatments. Meta-analysis has been criticized for the discrepancies between its findings and those of large clinical trials.^3-6 The frequency of discrepancies ranges from 10% to 23%³ and can often be explained by differences in treatment protocols or study populations or changes that occur over time.³

From the Department of Dermatology, Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, Mass (Dr Bigby); and the Centre of Evidence-Based Dermatology, Queen's Medical Centre, Nottingham, England (Dr Williams). The authors have no relevant financial interest in this article.

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