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The existing system of 6 years in elementary, and 4 years in secondary before entering tertiary is being challenged. It is the rigor of this review process that makes scientific journals the primary source of new information that impacts clinical decisionmaking and practice. The statement consists of a checklist of 27 essential items for transparent reporting and a flow diagram for the phases of study selection and is accompanied by the prisma explanation and elaboration document, which, among other things, provides examples of good reporting for the various review sections a further guidance on the reporting of systematic reviews has been published by the cochrane collaboration, an international organisation that prepares, updates and publishes systematic reviews of the effects of health-care interventions following a standardised format the question or hypothesis formulated by the investigator is the common starting point to search the relevant published literature for an answer...

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