Often, the available evidence is not sufficient to generate guidelines addressing the most critical questions faced by clinicians and patients.

Although there have been some major developments in severe traumatic brain injury (TBI) management, for other topics in this edition it was not possible to make new evidence-based recommendations.

The options are to wait for better evidence to be produced or to situate our reviews and guidelines in a larger enterprise.

Our vision is a recursive structure that includes ongoing publication monitoring, systematic reviews and synthesis, and guidelines that then contribute back to the development and execution of a research agenda that can provide the evidence base for more comprehensive guidelines.

We anticipate that this agenda also will promote the development and use of increasingly rigorous research methods in individual studies as well as reviews.

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