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In this blog interview Tom Jefferson shares with us which systematic review he would choose to take with him to read, if he was stranded on a desert island.

A beautiful deserted tropical island with white sand, turquoise seas, deep blue sky and palm trees, overlaid with a young woman with brown hair in a bun sitting in bed wrapped up in warm pale-coloured clothes, looking like she's coughing

Can you introduce yourself and share your role in the MSc EBHC (Systematic Reviews) program?
Hi everybody I am clinical epidemiologist and part-time archaeologist Tom Jefferson. I lecture on the Complex Reviews Course, the Philosophy and History of Medicine Course and from this summer on the Mapping Diseases: John Snow and Cholera course.

 I am one of the two editors of the substack Trust the Evidence and do other bits and pieces in between.

If you were stranded on a "Desert Island", which systematic review in might you take with you to read?
My first impulse in answering this question was “all of my reviews, as they are the best, all the others are rubbish”. However after administering myself an IV of Humilex a miraculous life-saving monoclonal antibody, I choose: Call SA, Vollenweider MA, Hornung CA, Simel DL, McKinney WP. Does This Patient Have Influenza? JAMA.2005;293(8):987–997. doi:10.1001/jama.293.8.98

What type of review was it?
The authors tried to answer the question of whether you can identify the causal agent behind an episode of influenza-like illness (ILI) from the presenting signs and symptoms. In true SR form they started with a cast of 911 hits and ended up with 10 studies. These compared presentation and physician diagnosis with the results of a disparate number of tests and worked out a likelihood ratio.

Why did you choose this review?
Hands up those of you who of you have had ILI this year. Hands up those of you who of you have had ILI in the last three years. That’s right, ILI is a common syndrome with variable presentations and humanity is very familiar with it. But it teaches those who have eyes to read and want to learn what the difference is between a syndrome: fever, fatigue, cough etc. and a disease: influenza, rhinovirus, bocavirus, RSV and so on, acute respiratory infection.

Finally, you may think that ILI would be an irrelevance in your lonely Robinson Crusoe-like existence. Think again. There is evidence from isolated communities of outbreaks both after weeks of isolation and when contact with humans is re-established.

What did the review show?
In those over 60 the combination of fever, cough, and acute onset makes the presence of influenza more likely, but not certain. All else is up for grabs. They also looked at rapid tests but this part is obsolete, and I would not sign up to fever as a reliable sign in an 80-year-old either.

What did you particularly enjoy about the review?
The review is permeated by uncertainty, it expresses it from every line, every paragraph, every table, every punctuation mark. It is, in other words, firmly grounded in curiosity, clinical medicine and science. It deals with a pedestrian topic, which is not so pedestrian and is the bread and butter of the primary care physician.

Reflecting on the review, what one learning would you offer individuals completing a systematic review for the first time?
Choose a topic that will be of benefit to you patients or constituents. Keep asking questions and never mind the noise. Define your aim and stick to it. And remember that uncertainty is the motor of science.

Finally, If you were stranded on a "Desert Island" and about to read the review, what one food or drink treat would you bring with you?
Vitamin C, of course


You can learn more about the MSc EBHC (Systematic Reviews) programme through the dedicated webpage or by contacting


The views expressed in this blog are those of the author and do not necessarily represent the views of CEBM as a group.