title: Coherence of evidence from systematic reviews as a basis for evidence strength - a case study in support of an epistemological proposition.
abstract: BACKGROUND
  This article aims to offer, on the basis of Coherence theory, the epistemological proposition that mutually supportive evidence from multiple systematic reviews may successfully refute radical, philosophical scepticism.
  
  
  METHODS
  A case study including seven systematic reviews is presented with the objective of refuting radical philosophical scepticism towards the belief that glass-ionomer cements (GIC) are beneficial in tooth caries therapy. The case study illustrates how principles of logical and empirical coherence may be applied as evidence in support of specific beliefs in healthcare.
  
  
  RESULTS
  The results show that radical scepticism may epistemologically be refuted on the basis of logical and empirical coherence. For success, several systematic reviews covering interconnected beliefs are needed. In praxis, these systematic reviews would also need to be of high quality and its conclusions based on reviewed high quality trials.
  
  
  CONCLUSIONS
  A refutation of radical philosophical scepticism to clinical evidence may be achieved, if and only if such evidence is based on the logical and empirical coherence of multiple systematic review results. Practical application also requires focus on the quality of the systematic reviews and reviewed trials.
authors.affiliation: SYSTEM Initiative/Department of Community Dentistry, Faculty of Health Sciences, University of the Witwatersrand, 7 York Rd,, Parktown/Johannesburg 2193, South Africa. neem@global.co.za.
authors.forename: Steffen
authors.initials: S
authors.lastname: Mickenautsch