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We are grateful to the commentators for their stimulating and constructive comments, and for the opportunity to respond. The commentators query the use of the flowchart in particular. Our intention was not to reduce all such decisions to a flowchart but to suggest one way of making explicit when a particular type of evidence may really be needed or not, in order to move the field beyond calls for more evidence, which may or may not contribute usefully to future decisions. Our intention was therefore to put the emphasis firmly back on the decision to be taken, rather than on the collection of evidence for unclear purposes. …
Competing interests None.
Provenance and peer review Not commissioned; internally peer reviewed.
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