In 2005 John Licciardone, Angela Brimhall, and Linda King published a systematic review and meta-analysis of randomized controlled trials with the title: Osteopathic manipulative treatment for low back pain. The conclusions of systematic review and meta-analysis depend highly on the right search strategy, the quality of the included studies (internal validity), and the error-free, unbiased and transparent evaluation of the review. As illustrated by the following article Licciardone's review includes elements that could lead to biased results. It is concluded that Licciardone et al. focused too much on the statistical significance, and overlooked that the problem of the review lay not in the calculations but in the quality and compilation of the studies.