THE LITERATURE OF MEDICINE The Medical Review Article: State of the Science

four major medical journals were assessed in a study of the methods of current review articles. Assessments were based on eight explicit criteria adapted from published guidelines for information syntheses. Of the 50 articles, 17 satisfied three of the eight criteria; 32 satisfied four or five criteria; and 1 satisfied six criteria. Most reviews had clearly specified purposes (n = 40) and conclusions (/? = 37). Only one had clearly specified methods of identifying, selecting, and validating included information. Qualitative synthesis was often used to integrate information included in the review (n = 43) ; quantitative synthesis was rarely used (n = 3). Future research directives were mentioned in 2 1. These results indicate that current medical reviews do not routinely use scientific methods to identify, assess, and synthesize information. The methods used in this systematic assessment of reviews are proposed to improve the quality of future review articles. G O O D REVIEW articles are precious commodities. In this era of a plentiful and burgeoning medical literature, the individual's capacity to read and absorb information has not changed. Reduction of large quantities of information into palatable pieces is essential for digestion. Adequate refinement of information calls for critical exploration, evaluation, and synthesis. The accomplished reviewer must tediously sift and sort data sources, sys-tematically appraise data quality, and thoughtfully inte-grate essential data into a unified whole. Such reviewers must synthesize data in a cogent and illuminating way, not just shuffle documents (1). Unfortunately medical reviews are often subjective, sci-entifically unsound, and inefficient (2). Strategies for identifying and selecting information are rarely defined. Collected information is reviewed haphazardly with little attention to systematic assessment of quality. Under such circumstances, cogent summarization is an arduous, if not insurmountable, task. The purpose of this article is twofold: to describe the methods of recently published review articles, and to demonstrate a systematic method for preparing review articles