SYSTEMATIC

You don't have to work at DynaMed for long to start to see how SYSTEMATIC our approach is to evidence processing. To be evidence-based is to follow explicit protocols, conduct CRITICAL APPRAISAL to reduce bias (evaluating things like INTENTION-TO-TREAT analysis and allocation concealment), to report the findings and the CERTAINTY of those findings, and to be transparent in processes and reporting.

All of this requires SYSTEMATIC approaches -- systems for following items through complex processes, systems for coordinating that changes in one area impact other areas when appropriate, systems for critical appraisal to ensure accuracy and replicability, systems for training, and systems for reporting results for clarity, ease of use and disambiguation.

If authors are "trained in evidence-based medicine" (ie, listen to a lecture or take a workshop) and then expected to create content without substantial systems for support and quality assurance, the results will likely not be evidence-based -- there are too many challenges in finding and selecting the best evidence, critically appraising evidence and synthesizing it well in the face of a substantial array of factors introducing bias in the original evidence development, in the summarization of evidence in publications, and in the handling by the authors themselves.

As things get more complex or more CRITICAL ("must not miss") it becomes more important to have systems to support our work. For any work that you do, consider areas where you can be more SYSTEMATIC.