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Letter in reply to 'Evidence pyramids' from Dr Kaufmann
  1. Terrence Shaneyfelt
  1. Correspondence to : Dr Terrence Shaneyfelt
    , Division of Primary Care, Department of Veterans Affairs, 700 S 19th Street, Birmingham, AL 35233, USA; terry.shaneyfelt{at}med.va.gov

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Dr Kaufmann makes an important point that quality varies in primary studies and that one should be sceptical when reading the medical literature. Systematic review of poor quality evidence does not make that evidence more valid. Dr Kaufmann suggests that by reviewing the primary …

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