The evidence base for our clinical interventions is actually quite weak. RCTs are often small, unblinded, and suffer design flaws. Standard of care interventions often only have one trial. Publication bias is rampant.
We need systematic review-level evidence. The development of systematic reviews is completely not systematic. They are underfunded by agencies, under-demanded by clinicians.
To address this we can use crowd-sourcing and automation to enter data, perform meta-analysis, and create ample and open post-publication review.
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