As medical scientists, we need to avoid becoming onihilistico in dismissing the clinical effectiveness of any treatment because it does not rigidly meet a so-called ospecific quality assessment methodo criteria developed by a particular group. Concato et al.  have appropriately emphasized this point. Moreover, Oxman and Guyatt , who Hoving et al.  cite as providing some of the methodology used in their Cochrane review of nonoperative treatment of neck pain, have clearly discussed the fact that judging the validity of an outcome is frequently not as simple as merely identifying the type of research design used, or simply assessing the general characteristics of a study. This is true for both of the Cochrane reviews we have examined in this editorial. Neck pain, which was the focus of the Hoving et al.  Cochrane review, is a common musculoskeletal symptom.