Availability of evidence and comparative effectiveness for surgical versus drug interventions: an overview of systematic reviews.

An assessment of the entire Cochrane Database of Systematic Reviews found 188 reviews that intended to assess surgical versus drug interventions, but only 41 had at least one randomized trial.Only four of the 103 assessed outcomes had high strength of evidence according to GRADE assessments.More evidence is needed to compare the relative merits of surgical and drug interventions and sequestration of these major modes of interventions should be overcome in clinical trial agendas.