The medical literature is expanding rapidly, with thousands of new studies published each year. Increasingly, clinicians and scientists rely on rigorous syntheses of the scientific literature, such as high-quality systematic reviews and meta-analyses, which the Oxford Centre for Evidence-Based Medicine considers the highest level of scientific evidence available.1 However, systematic reviews and meta-analyses are typically based on the published literature, which is known to be biased,2- 4 creating an important question: can we trust the highest level of evidence available in MEDLINE?
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