Where Have All the Experienced Clinicians Gone? How the Literature on Care of Older Persons Fails to Adequately Inform Clinical Decision Making

From our vantage point as journal editors, it's clear that we're in an era where systematic reviews and meta-analyses are the favored form of literature critique and synthesis. Of the last 50 review articles submitted to JAMDA, 38 had titles that included “systematic review,” “meta-analysis,” or both terms. This preponderance is not surprising, given that systematic reviews are prized as high quality evidence.1,2 Furthermore, much of the academic literature is written by trainees who are expected to conduct research and publish their findings, and a characteristic of the systematic review is that it can be conducted by someone with relatively little knowledge of or experience with the topic of study.