Seventy-Five Trials and Eleven Systematic Reviews a Day: How Will We Ever Keep Up?

TLDR

The rapid expansion of clinical trials—now 75 per day—has outpaced systematic reviews, leaving most trial data unexamined and leaving narrative reviews as the primary synthesis method. The study aims to reduce unnecessary trials, prioritize systematic reviews, and provide open access by streamlining review methods to better serve patients, clinicians, and policymakers. The authors propose streamlining and innovating systematic review methods to efficiently generate valid answers for most patient questions. Currently, 75 trials and 11 systematic reviews are published daily, and without major changes, Cochrane's goal of comprehensive evidence synthesis remains unattainable.

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.