A team of international experts led by a Mayo Clinic researcher has published in the Journal of the American Medical Association a guide for clinicians who are interested in using systematic reviews and meta-analysis in clinical decision making. This article is the latest in the well-known series of usersâ€™ guides to the medical literature that JAMA started publishing in the mid 1990s and is highly sought after by clinicians who want to learn and practice evidence based medicine. â€śWhen searching for evidence to answer a clinical question, itâ€™s better to seek a systematic review, especially one that includes a meta-analysis,â€ť says M. Hassan Murad, M.D., Knowledge Synthesis Program, Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery. â€śSingle studies are liable to be unrepresentative of the total evidence and can be misleading.â€ť Systematic reviews include a greater range of patients than any single study, while meta-analysis of a body of evidence includes a larger sample size and more events than any individual study, the authors note. They recommend that providers assess these studies by using two judgments: First judgment: Evaluate the credibility of the methods of the systematic review. Credibility may be undermined by inappropriate eligibility criteria, inadequate literature search or failure to optimally summarize results. Second judgment: Rate the confidence in the effect estimates. Common reasons for lower confidence include high risk of bias of the individual studies, inconsistent results and small sample size. â€śUltimately, clinicians have to ask if the results can directly apply to their patients,â€ť Dr. Murad says.