title: The medical review article revisited: has the science improved?
abstract: BACKGROUND
  The validity of a review depends on its methodologic quality.
  
  
  OBJECTIVE
  To determine the methodologic quality of recently published review articles.
  
  
  METHODS
  Critical appraisal.
  
  
  METHODS
  All reviews of clinical topics published in six general medical journals in 1996.
  
  
  METHODS
  Explicit criteria that have been published and validated were used.
  
  
  RESULTS
  Of 158 review articles, only 2 satisfied all 10 methodologic criteria (median number of criteria satisfied, 1). Less than a quarter of the articles described how evidence was identified, evaluated, or integrated; 34% addressed a focused clinical question; and 39% identified gaps in existing knowledge. Of the 111 reviews that made treatment recommendations, 48% provided an estimate of the magnitude of potential benefits (and 34%, the potential adverse effects) of the treatment options, 45% cited randomized clinical trials to support their recommendations, and only 6% made any reference to costs.
  
  
  CONCLUSIONS
  The methodologic quality of clinical review articles is highly variable, and many of these articles do not specify systematic methods.
authors.affiliation: University of Oxford, United Kingdom. Finlay.McAlister@ualberta.ca
authors.forename: F A
authors.initials: FA
authors.lastname: McAlister
authors.forename: H D
authors.initials: HD
authors.lastname: Clark
authors.forename: C
authors.initials: C
authors.lastname: van Walraven
authors.forename: S E
authors.initials: SE
authors.lastname: Straus
authors.forename: F M
authors.initials: FM
authors.lastname: Lawson
authors.forename: D
authors.initials: D
authors.lastname: Moher
authors.forename: C D
authors.initials: CD
authors.lastname: Mulrow
mesh_terms: D015706:Bibliometrics; D006801:Humans; D010506:Periodicals as Topic / Q000592:standards*; D012106:Research / Q000592:standards; D012107:Research Design; D012196:Review Literature as Topic