Focus is the new intelligence quotient for evidence-based practice.

The focus of most individuals and organizations working in the field of evidence-based healthcare (EBHC) is to operationalize evidence. Few would argue that the primary driver and ultimate objective of EBHC is to see it utilized to inform policy and practice that results in improved outcomes for patients. However, it is hard not to think of the infinity pool as a metaphor for the potentially limitless endeavour of methodological reflection, refinement and reconceptualization that many of us as evidence-based researchers seek to achieve. Diving into ‘methodological infinity pools’ (or down rabbit holes – you can choose whichever symbolism or imagery works best for you) can result in fresh, unexpected salience. There is no doubt that some benefit can come from considering tangential ways of thinking about some of the problems we seek to solve. Nevertheless, these tangents are not always necessarily productive or pragmatic and need to be tempered accordingly. The value proposition of systematic reviews in this context has been their ability to provide rigorously reviewed and synthesized trustworthy evidence. It is therefore critical that we deliver on that promise and invest in ensuring the highest quality result for key stakeholders. To that end, methodological advances in the science and timely delivery and update of evidence syntheses continue at a rapid rate. A considerable number of new methodological approaches are now appearing for different types of evidence, and there are also an increasing number of tools available to assist in improving reporting and methodological quality in the conduct of systematic reviews (QUOROM, PRISMA, AMSTAR, COSMIN, MOOSE, OQAQ, ROBIS). However, despite the existence of such tools common errors persist, including use of incomplete guidance, incorrect use of reporting tools and checklists or use of tolls in isolation without reference to methodological guidance for the conduct of reviews. Significant criticism has also been levelled at the science that currently underpins the conduct of systematic reviews and, in particular, meta-analyses. Prominent, experienced synthesis science scholars like John Ionnidis and Jos Kleijnen (among others) have been frequently cited for their observations regarding issues related to