Editorial Perspective: Time for Another Grading System—From PRISMA to AMSTAR 2

摘要

This is an important critical reassessment regarding the proliferative publication trend of “Systematic Reviews” seen not just in just spine surgery but across all medical specialties. With the advent of the “evidence-based medicine” era, the traditional hierarchy of evidence, which had historically held prospectively randomized clinical trials at the very pinnacle of the evidence pyramid, was rearranged in favor of “well-performed” systematic reviews (SRs) and metaanalyses (MAs).1 With their overarching and collective nature, these undertakings can offer a statistically much more potent literature overview while potentially reducing bias almost invariably introduced in single studies.2,3 Undeniably, SRs and MAs have become essential foundations for guidelines (ie, National Institute for Health and Care Excellence [NICE] guidelines), they are the “go-to” first look resource for government agencies and granting bodies alike. And for future authors, such studies have become a welcome primary entry point for a deeper dive towards their own research projects.