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t is increasingly recognized that health care decision-making around the world needs to be informed by high quality and timely research evidence. The randomized controlled trial (RCT) has long been considered the “gold standard ” in the hierarchy of evidence; randomized trials, involving sufficient numbers of participants, are essential to distinguish reliably between the effects of health care interventions and the effects of bias or chance. The synthesis of the results of these trials in systematic reviews can provide reliable evidence about the effects of these interventions. The Cochrane Collaboration is an international organization dedicated to improving health care for the world’s population by preparing, maintaining, and promoting the accessibility of Cochrane systematic reviews of the evidence of the effects of health care interventions. The validity of the results of a systematic review is highly dependent on the data included and a prerequisite is to include as unbiased and complete a set of relevant studies as possible. The Cochrane Collaboration has focused on the systematic electronic searching of MEDLINE and EMBASE and the systematic handsearching of currently over 2000 general and specialized health care journals for reports of RCTs.1 This handsearching involves reading each document in a journal to decide, according to the set Cochrane eligibility criteria,2 if it might be a report of a randomized trial. The efforts of the many volunteers working within The Cochrane Collaboration have added a substantial number of previously “buried ” reports of RCTs to The Cochrane Central Register of Controlled Trials
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