One of the most powerful arguments used by the supporters of systematic reviews is that they overcome most of the limitations of narrative reviews by being the product of a scientific process to reduce bias and imprecision and by providing detailed information to allow replication by others.1,2 Two of the most effective mechanisms for a systematic review to reduce bias and imprecision are including the maximum possible number of relevant individual trials and providing a detailed description of their strengths and limitations. We have structured this article to serve 2 purposes. First, we describe the characteristics of the ideal search, the limitations and decisions that most reviewers face when deciding how to search the literature, and the aspects of a report that readers should evaluate to assess the comprehensiveness and appropriateness of the search strategy. Second, we describe the limitations and decisions that most reviewers face when deciding how to assess trial quality and the aspects of a report that readers should evaluate to determine how trial quality has been assessed and the appropriateness of the assessments.
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