Systematic reviews serve as a fundamental basis for evidence-based decisions in healthcare, but their mass production and often inadequate quality jeopardize this claim. In an article in the Journal for Evidence, Training and Quality in Health Care, members of the Network for Evidence-Based Medicine warn of the consequences of this development and call for a change of course: Fewer reviews, but more methodologically convincing. The freely accessible article names causes, presents possible solutions and appeals to all those involved in the process to act.

The number of systematic reviews is continuously increasing, often with overlapping questions and considerable methodological deficits. This undermines their trustworthiness and has implications for science, care and policy. The problem has been debated internationally for a long time, but awareness of it remains limited in German-speaking countries. In the current article, a group of authors from the Evidence-Based Medicine Network draws attention to this problem and explains why many reviews do not achieve the required quality for solid decisions.

The main causes are insufficient methodological knowledge, a lack of coordination in the choice of topics and insufficient quality controls. These shortcomings weaken the validity of the reviews and lead to misinterpretations. The article goes beyond analysis and outlines concrete approaches for improvement, including stronger prioritization of relevant topics, stricter quality specifications and more transparency in planning and implementation. The call is aimed at everyone who commissions, creates, checks, publishes or applies reviews.

In particular, editors of scientific journals, research sponsors, professional societies and institutions are called upon to put quality before quantity and to establish appropriate structures. Healthcare decision-makers use high-quality reviews and have an interest in strengthening their standards. The article is deliberately written in German and is available open access in order to raise awareness in German-speaking countries and stimulate a comprehensive debate.

For the Evidence-Based Medicine Network, one thing is certain: Only through the joint commitment of all those involved can systematic reviews once again become a solid, transparent and trustworthy basis for scientifically sound decisions on health-related issues. The authors will present their results and proposals on March 9, 2026 from 4:30 p.m. to 6:00 p.m. in an online forum of the network and discuss them with participants. Interested parties can participate in the event and ask questions about the realization of high-quality reviews.

The mass production of reviews ties up resources that might be lacking for original research and overwhelms users with redundant content. Methodological weaknesses, such as incomplete search strategies or a lack of bias scores, lead to distorted conclusions. International debates, for example in specialist journals such as the British Medical Journal, underline the urgency. In the German-speaking world, the article could lead to a broader debate and raise standards.

Solutions include registration systems for scheduled reviews to avoid duplication, as well as methodology training. Sponsors could tighten criteria to support only high-quality projects. Journals could optimize peer review processes and use checklists. Users in politics and clinics should critically examine reviews, for example on the basis of AMSTAR criteria. Such measures could strengthen the evidence base.

The appeal emphasizes the responsibility of all actors: Without coordination, there is a risk of an erosion of trust in scientific synthesis work. In a time of complex health policy challenges, reliable reviews are essential. The contribution could provide impetus for reforms and contribute to a more efficient use of resources. The planned forum offers a platform to exchange ideas and develop concrete steps.

Original Paper:

We need fewer but better systematic reviews! A call for action – Journal for Evidence, Training and Quality in Health Care

Editor: X-Press Journalistenbüro GbR

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