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Hi Jon, These are my thoughts that came up when reading your pointers. 1)SRs reliably confirm when people want to medicalise the population. The important thing is to come up with a tool that will be used by others. For example, for antidepressants the PHQ-9 as devised by Pfizer, rather than using Warwick Endinburgh Mental Wellbeing scale http://www.experiential-researchers.org/instruments/leijssen/WEMWBS.pdf or HbA1c levels for all the NIDDM medications, rather than teach patients about curing themselves with low carbohydrate diets, or with not reality based assessments (patient relevant outcomes), like TND for VE of influenza vaccines. Overall SR keep focusing on disease model of thinking rather than what maintains health. 2)SRs are reliable in relation to what the researcher wants to prove 3)I think SRs are best described as an assembly of collective thinking up to that moment in time in a particular area, a show of following the EBM "party line"? I agree that up to now SR are value based (disease model of thinking), based on fear and having faith in being able to fight disease rather than having faith in initiating new research that focuses on supporting health? Dr W Havinga, locum GP, Gloucestershire, UK GMC 3578256 @wouterhavinga