Systematic reviews and meta-analyses on treatment of asthma: critical evaluation
BMJPublished 26 February 2000Open access
Alejandro R. Jadad
Citations258
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ObjectiveStudy objective
MethodsResearch methodology
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Sample sizeSample sizes
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TL;DR
Most reviews published in peer reviewed journals or funded by industry have serious methodological flaws that limit their value to guide decisions, but Cochrane reviews are more rigorous and better reported than those published inpeer reviewed journals.
Abstract
Most reviews published in peer reviewed journals or funded by industry have serious methodological flaws that limit their value to guide decisions. Cochrane reviews are more rigorous and better reported than those published in peer reviewed journals.
Keywords
Decision SciencesMedicineNeuroscience
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