Abstract
Abstract Systematic reviews and large randomized trials constitute the most reliable sources of evidence we can muster (Table 2.1). Put simply, they are the best chance we have to determine what is true. We discuss how to find trials, and how to appraise their quality. Further on there is advice on how to appraise the quality of systematic reviews themselves. The randomized controlled trial (RCT) is the most reliable way to estimate the effect of an intervention. The simple principle of randomization is that each randomized patient has the same probability of receiving any of the interventions being compared. Randomization abolishes selection bias because it prevents investigators influencing who has which intervention. Randomization also helps to ensure that other factors, such as age or sex distribution, are equivalent for the different treatment groups. Inadequate randomization, or inadequate concealment of randomization, lead to exaggeration of therapeutic effect.
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