In the Era of Systematic Reviews, Does the Size of an Individual Trial Still Matter?

BACKGROUND TO THE DEBATE: Systematic reviews that combine high-quality evidence from several trials are now widely considered to be at the top of the hierarchy of clinical evidence. Given the primacy of systematic reviews-and the fact that individual clinical trials rarely provide definitive answers to a clinical research question-some commentators question whether the sample size calculation for an individual trial still matters. Others point out that small trials can still be potentially misleading.