Table 1.

Problem arising from consensus‐based approach and proposed solutions by an evidence‐based approach

Problem of a consensus‐based approach	Solution by an evidence‐based approach	Potential problems not solved by an evidence‐based approach
Risk of missing relevant research	Comprehensive searching which is part of systematic reviewing may improve identification of important literature. A structured, systematic process allows summarizing and evaluating complex information such as big data or basic research information provided for molecular pathology.	Risk of missing research which does not fit into standard study design framework used for systematic reviews. Publication bias may not be addressed if only searching published evidence.
Selection of the literature may be biased	Systematic reviews require clearly stated inclusion criteria, so cherry‐picking of particular studies to prove a particular point is easier to spot. In addition, the setting of acceptable evidence levels and assessment of risk of bias of studies avoids the use of inappropriate evidence.	Presentation of results may still allow a certain degree of “cherry‐picking” when presenting only on selected outcomes (outcome reporting bias).
Interpretation of the literature may be biased	Systematic reviews consider each included study equally, unless there is a specific reason why less emphasis should be placed on it such as small sample or poor study quality. Risk of bias assessment of individual studies, but also the body of evidence can be undertaken to aid an appropriate interpretation of the retrieved evidence.	The use of several reviewers may not provide the desired control of bias effect and instead interesting information, may not be incorporated due to disagreement.
Panel of experts may be biased in composition or be dominated by particular individuals	A systematic review with clear eligibility criteria made available in a protocol may provide a reference point against which “extreme” views by particular panel members can be mitigated.	Panel may still be biased in developing eligibility criteria, even if an evidence‐based approach helps in the discussion.
Difficulties in documentation of included evidence (especially in the updating process)	Systematic review protocol and reports document the biomedical databases searched and over what time period therefore uncertainty about whether a particular study has been included or not is much less likely to occur.	Relies on the well‐designed and appropriate literature searches and implementation of reporting standards for systematic reviews.
Credibility of classification may be undermined if not evidence‐based	Use of systematic review methods will improve the credibility of the classification, as well as the reliability of tumour classification.	Credibility may also be affected by other factors not addressed by a systematic review process. Experts in the field, important to the credibility of the books, may be put‐off by the systematic review process.