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[Correspondence] Systematic reviews and research waste

Whether or not all available trials should be included in a meta-analysis has been debated for many years.1 Ian Roberts and Katharine Ker2 argue that systematic reviews increase waste in research by promoting underpowered trials. We disagree and argue that a systematic review is not wasteful if it includes small studies; underpowered trials might be acceptable if investigators use methodological rigor to eliminate bias, thoroughly report results to avoid misinterpretation, and always publish results to avoid publication bias.