individually, are able to contribute to advancing the field as well. However, the committee believes that collaborative relationships among agencies, both public and private, would be most effective at contributing to progress. Furthermore, the committee recognizes that U.S. developments are only part of a substantial international effort focused on how best to conduct SRs, an effort that in some countries is advanced and highly sophisticated. Given the potential for duplication of efforts, the need to ensure that gaps in the information base are appropriately addressed, and the need for efficient use of limited available resources, the coordination across multiple organizations within the United States and throughout the world will have clear benefits and should be viewed as essential.

IMPROVING THE SCIENCE OF SYSTEMATIC REVIEWS

Establishing a process for ongoing development of the research agenda in SRs must be an important part of the path forward. Although the committee believes the recommended standards and elements of performance presented in this report are founded on the best available evidence and current practice of respected organizations, all SR standards should be considered provisional pending additional experience and research on SR methods. The committee recognizes that each of its recommended standards could be examined in appropriately designed research, with the expectation that some items would be validated, some discarded, and some added. Future research to develop methods that promote efficiency and scientific rigor is especially important. A detailed description of research that might be conducted on each step, however, is outside the committee’s scope of work and would require substantial time and resources. We also note that some of the needed work may be more appropriately categorized as program development and evaluation than research.

The committee promotes the goal of developing a coordinated approach to improving the science of SR, embedded in a program of innovation, implementation, and evaluation that improves the quality of SRs overall. PCORI is an appropriate organization to provide comprehensive oversight and coordination of the development of the science of SRs in support of CER, in cooperation with agencies of the U.S. Department of Health and Human Services (HHS). It could, also function as an important U.S. collaborator with international organizations similarly focused (e.g., Cochrane Collaboration, Campbell Collaboration, and CRD). Among other goals, such a coordinated program would support a description of methods currently



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