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Evidence-based practice involves the use of current, bestavailable evidence to inform clinical care decisions. 1 To assist with categorizing evidence quality, evidence hierarchies,(also known as “evidence pyramids”), aim to rank study designs from those having the least to the greatest potential for bias to answer research questions. Although various configurations exist, most hierarchies place well-conducted systematic reviews at their peak, as “level 1” evidence. This position recognizes that rigorous systematic reviews aim to maximize transparency and reduce bias at all stages of the review process, by using clearly formulated questions, and systematic and explicit methods, to identify, select, critically appraise, collate, and synthesize relevant research. The ideal output should be readily digestible by end-users, often clinicians and policymakers, to inform evidence-based decision-making. Systematic reviews may …