This series of 18 articles describes processes for ensuring that relevant research is identified, appraised and used to inform decisions about health policies and programs. The tools were written for people responsible for health policy decision-making (e.g., health system managers and policy-makers) and for those who support them.

CHSRF worked in partnership with the SUPPORT Project to bring you the French version of this series. SUPPORT is an international collaboration network that provides training and support to encourage researchers and policy-makers in collaborative policy-relevant research.

A book version of SUPPORT Tools for evidence-informed health Policymaking (STP) is also available.

Support Tools

Deciding how much confidence to place in a systematic review

by Simon Lewin, Andrew D Oxman, John N Lavis, Atle Fretheim | Dec 16, 2009

Full text | PDF


The reliability of systematic reviews of the effects of health interventions is variable. Consequently, policymakers and others need to assess how much confidence can be placed in such evidence. The use of systematic and transparent processes to determine such decisions can help to prevent the introduction of errors and bias in these judgements.

In this article, we suggest five questions that can be considered when deciding how much confidence to place in the findings of a systematic review of the effects of an intervention. These are:

  1. Did the review explicitly address an appropriate policy or management question?
  2. Were appropriate criteria used when considering studies for the review?
  3. Was the search for relevant studies detailed and reasonably comprehensive?
  4. Were assessments of the studies' relevance to the review topic and of their risk of bias reproducible?
  5. Were the results similar from study to study?