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. 2010 Sep 21;7(9):e1000326.
doi: 10.1371/journal.pmed.1000326.

Seventy-five trials and eleven systematic reviews a day: how will we ever keep up?

Hilda Bastian  1 , Paul Glasziou, Iain Chalmers
Affiliations

Seventy-five trials and eleven systematic reviews a day: how will we ever keep up?

Hilda Bastian et al. PLoS Med. .

Abstract

When Archie Cochrane reproached the medical profession for not having critical summaries of all randomised controlled trials, about 14 reports of trials were being published per day. There are now 75 trials, and 11 systematic reviews of trials, per day and a plateau in growth has not yet been reached. Although trials, reviews, and health technology assessments have undoubtedly had major impacts, the staple of medical literature synthesis remains the non-systematic narrative review. Only a small minority of trial reports are being analysed in up-to-date systematic reviews. Given the constraints, Archie Cochrane's vision will not be achieved without some serious changes in course. To meet the needs of patients, clinicians, and policymakers, unnecessary trials need to be reduced, and systematic reviews need to be prioritised. Streamlining and innovation in methods of systematic reviewing are necessary to enable valid answers to be found for most patient questions. Finally, clinicians and patients require open access to these important resources.

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Conflict of interest statement

HB works for a health technology assessment agency.

Figures

Figure 1
Figure 1. Policy and academic milestones in the development of trials and the science of reviewing trials.
Figure 2
Figure 2. The number of published trials, 1950 to 2007.
CCTR is the Cochrane Controlled Trials Registry; Haynes filter uses the “narrow” version of the Therapy filter in PubMed:ClinicalQueries; see Text S1.
Figure 3
Figure 3. The number of systematic reviews in health care, 1990 to 2007.
INAHTA is International Network of Agencies for Health Technology Assessment; the Montori systematic review filter is detailed in Text S1.
Figure 4
Figure 4. The rise in non-systematic reviews, case reports, trials, and systematic reviews, 1950 to 2007 (as identified in MEDLINE).
See this image and copyright information in PMC

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