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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.

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