We would like to thank Drs. Dahm, Narayan, and Jung for their thoughtful and well-argued comments on our paper . However, it would appear that they have misinterpreted the main point of the article, which is to help guideline developers resolve conflicting findings between large, multicentre, and robust randomized controlled trials (RCTs) and those of systematic reviews and meta-analyses (MA). This issue goes beyond “conflicting results of different studies” within MAs, especially when the MA largely consists of small, underpowered, heterogeneous studies with a high risk of bias and/or poor reporting.
Lam, T. B. L., Sylvester, R. J., Canfield, S. E., Marconi, L., MacLennan, S., Yuan, Y., ... N'Dow, J. (2017). Reply to Philipp Dahm, Vikram Narayan, and Jae Hung Jung's Letter to the Editor re: Richard J. Sylvester, Steven E. Canfield, Thomas B.L. Lam, et al. Conflict of Evidence: Resolving Discrepancies When Findings from Randomized Controlled Trials and Meta-analyses Disagree. Eur Urol 2017;71:811-9. European Urology, 72(4), e93-e94. https://doi.org/10.1016/j.eururo.2017.04.008