A recent article published in the Journal of Clinical Sleep Medicine showed that a lower proportion of published articles in sleep medicine were systematic reviews or meta-analyses. The authors suggested that systematic reviews and meta-analyses were underused in sleep medicine. Normally, this would not be cause for alarm, but I was prompted to speak up.

Their conclusion was at odds with other research findings, so I submitted a letter to the journal that was just published. This highlighted the overwhelming evidence that most published systematic reviews and meta-analyses in medical journals are of poor quality. Specifically, an international group just published their work finding that published systematic reviews and meta-analyses in sleep medicine have multiple critical flaws, on average. Similarly, we have shown that 99% of the published systematic reviews and meta-analyses in high-impact otolaryngology journals provided critically low confidence in the results. I have written previously on this blog about this work and its implications.

I propose that we in sleep medicine should be focusing on high-quality research that is the foundation of high-quality systematic reviews. In an era of finite resources, we should not distract ourselves with reviews of research studies that can have important flaws. High-quality systematic reviews should point to the gaps in our literature, but the reality is that the rush to publication has allowed authors (and journals) to overlook these flaws and present “research findings” that become the basis of patient care.

We can do better than this.