Pediatric dentistry systematic reviews using the GRADE approach: methodological study.
Child
Clinical trial
Dental care
Meta-analysis
Oral health
Overview, GRADE approach
Pediatric dentistry
Systematic review
Journal
BMC oral health
ISSN: 1472-6831
Titre abrégé: BMC Oral Health
Pays: England
ID NLM: 101088684
Informations de publication
Date de publication:
13 Jul 2024
13 Jul 2024
Historique:
received:
13
11
2023
accepted:
27
06
2024
medline:
14
7
2024
pubmed:
14
7
2024
entrez:
13
7
2024
Statut:
epublish
Résumé
To assess the reporting of the certainty of the evidence using the GRADE approach in systematic reviews of interventions in pediatric dentistry. The inclusion criteria were systematic reviews of randomized clinical trials (RCTs) and non-randomized studies of interventions (NRSIs) in pediatric dentistry that reported the certainty of the evidence through the GRADE approach. Paired independent reviewers screened the studies, extracted data, and appraised the methodological quality using the Assessing the Methodological Quality of Systematic Reviews (AMSTAR 2) tool. The certainty of the evidence was extracted for each outcome. A descriptive analysis was conducted. Around 28% of pediatric dentistry reviews of interventions used the GRADE approach (n = 24). Twenty reviews reported 112 evidence outcomes from RCTs and 13 from NRSIs using GRADE evidence profile tables. The methodological quality was high (16.7%), moderate (12.5%), low (37.5%), and critically low (33.3%), fulfilling the majority of the AMSTAR 2 criteria. The certainty of the evidence for outcomes generated from RCTs and NRSIs was very low (40.2% and 84.6%), low (33.1% and 7.7%), moderate (17.8% and 7.7%), and high (9.8% and 0.0%). The main reasons to downgrade the certainty were due to (for RCTs and NRSIs, respectively): risk of bias (68.8% and 84.6%), imprecision (67.8% and 100.0%), inconsistency (18.8% and 23.1%), indirectness (17.8% and 0.0%), and publication bias (7.1% and 0.0%). The proportion of systematic reviews assessing the certainty of the evidence using the GRADE approach was considered small, considering the total initial number of published pediatric dentistry reviews of intervention. The certainty of the evidence was mainly very low and low, and the main problems for downgrading the certainty of evidence were due to risk of bias and imprecision. PROSPERO database #CRD42022365443.
Sections du résumé
BACKGROUND
BACKGROUND
To assess the reporting of the certainty of the evidence using the GRADE approach in systematic reviews of interventions in pediatric dentistry.
METHODS
METHODS
The inclusion criteria were systematic reviews of randomized clinical trials (RCTs) and non-randomized studies of interventions (NRSIs) in pediatric dentistry that reported the certainty of the evidence through the GRADE approach. Paired independent reviewers screened the studies, extracted data, and appraised the methodological quality using the Assessing the Methodological Quality of Systematic Reviews (AMSTAR 2) tool. The certainty of the evidence was extracted for each outcome. A descriptive analysis was conducted.
RESULTS
RESULTS
Around 28% of pediatric dentistry reviews of interventions used the GRADE approach (n = 24). Twenty reviews reported 112 evidence outcomes from RCTs and 13 from NRSIs using GRADE evidence profile tables. The methodological quality was high (16.7%), moderate (12.5%), low (37.5%), and critically low (33.3%), fulfilling the majority of the AMSTAR 2 criteria. The certainty of the evidence for outcomes generated from RCTs and NRSIs was very low (40.2% and 84.6%), low (33.1% and 7.7%), moderate (17.8% and 7.7%), and high (9.8% and 0.0%). The main reasons to downgrade the certainty were due to (for RCTs and NRSIs, respectively): risk of bias (68.8% and 84.6%), imprecision (67.8% and 100.0%), inconsistency (18.8% and 23.1%), indirectness (17.8% and 0.0%), and publication bias (7.1% and 0.0%).
CONCLUSION
CONCLUSIONS
The proportion of systematic reviews assessing the certainty of the evidence using the GRADE approach was considered small, considering the total initial number of published pediatric dentistry reviews of intervention. The certainty of the evidence was mainly very low and low, and the main problems for downgrading the certainty of evidence were due to risk of bias and imprecision.
REGISTRATION
BACKGROUND
PROSPERO database #CRD42022365443.
Identifiants
pubmed: 39003480
doi: 10.1186/s12903-024-04542-w
pii: 10.1186/s12903-024-04542-w
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
787Subventions
Organisme : Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
ID : 001
Organisme : Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
ID : 001
Organisme : Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
ID : 001
Organisme : Fundação de Amparo à Pesquisa do Estado de Minas Gerais
ID : APQ-00323-17
Organisme : Fundação de Amparo à Pesquisa do Estado de Minas Gerais
ID : APQ-00323-17
Informations de copyright
© 2024. The Author(s).
Références
Smail-Faugeron V, Fron-Chabouis H, Courson F. Methodological quality and implications for practice of systematic Cochrane reviews in pediatric oral health: a critical assessment. BMC Oral Health. 2014;14:35.
doi: 10.1186/1472-6831-14-35
pubmed: 24716532
pmcid: 4108002
Pandis N, Fleming PS, Worthington H, Salanti G. The quality of the evidence according to GRADE is predominantly low or very low in oral health systematic reviews. PLoS ONE. 2015;10(7):e0131644.
doi: 10.1371/journal.pone.0131644
pubmed: 26162076
pmcid: 4498810
Fleming PS, Koletsi D, Ioannidis JP, Pandis N. High quality of the evidence for medical and other health-related interventions was uncommon in Cochrane systematic reviews. J Clin Epidemiol. 2016;78:34–42.
doi: 10.1016/j.jclinepi.2016.03.012
pubmed: 27032875
Notaro SQ, Hermont AP, Cruz PV, Maia RM, Avila WM, Poklepovic Pericic T, Abreu LG, Jiao R, Martins-Pfeifer C. Methodological quality of systematic reviews addressing orthodontic interventions: methodological study. Pesq Bras Odontop Clin Int. 2024;24:e230074.
doi: 10.1590/pboci.2024.040
Pereira AG, Martins CC, Campos JR, Faria SF, Notaro SQ, Poklepovic-Pericic T, Costa LC, Costa FO, Cota LO. Critical appraisal of systematic reviews of intervention studies in periodontology using AMSTAR 2 and ROBIS tools. J Clin Exp Dent. 2023;15(8):e678–94.
doi: 10.4317/jced.60197
pubmed: 37674600
pmcid: 10478201
Pauletto P, Polmann H, Reus JC, de Oliveira JMD, Chaves D, Lehmkuhl K, Massignan C, Stefani CM, Martins CC, Flores-Mir C, De Canto L. G: Critical appraisal of systematic reviews of intervention in dentistry published between 2019–2020 using the AMSTAR 2 tool. Evid Based Dent 2022.
Atkins D, Best D, Briss PA, Eccles M, Falck-Ytter Y, Flottorp S, Guyatt GH, Harbour RT, Haugh MC, Henry D, et al. Grading quality of evidence and strength of recommendations. BMJ. 2004;328(7454):1490.
doi: 10.1136/bmj.328.7454.1490
pubmed: 15205295
Mejare IA, Klingberg G, Mowafi FK, Stecksen-Blicks C, Twetman SH, Tranaeus SH. A systematic map of systematic reviews in pediatric dentistry–what do we really know? PLoS ONE. 2015;10(2):e0117537.
doi: 10.1371/journal.pone.0117537
pubmed: 25706629
pmcid: 4338212
Page MJ, Moher D, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, Shamseer L, Tetzlaff JM, Akl EA, Brennan SE, et al. PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews. BMJ. 2021;372:n160.
doi: 10.1136/bmj.n160
pubmed: 33781993
pmcid: 8005925
Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ. Welch VAe: Cochrane Handbook for Systematic Reviews of Interventions version 6.4 (updated August 2023). Cochrane, 2023. www.training.cochrane.org/handbook .
Guyatt GH, Oxman AD, Vist GE, Kunz R, Falck-Ytter Y, Alonso-Coello P, Schunemann HJ. Group GW: GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ. 2008;336(7650):924–6.
doi: 10.1136/bmj.39489.470347.AD
pubmed: 18436948
pmcid: 2335261
Shea BJ, Reeves BC, Wells G, Thuku M, Hamel C, Moran J, Moher D, Tugwell P, Welch V, Kristjansson E, Henry DA. AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ. 2017;358:j4008.
doi: 10.1136/bmj.j4008
pubmed: 28935701
pmcid: 5833365
Lai YYL, Zafar S, Leonard HM, Walsh LJ, Downs JA. Oral health education and promotion in special needs children: systematic review and meta-analysis. Oral Dis. 2022;28(1):66–75.
doi: 10.1111/odi.13731
pubmed: 33215786
Davidovich E, Shafir S, Shay B, Zini A. Plaque removal by a Powered Toothbrush Versus a Manual Toothbrush in children: a systematic review and Meta-analysis. Pediatr Dent. 2020;42(4):280–7.
pubmed: 32847667
Santos GM, Pacheco RL, Bussadori SK, Santos EM, Riera R, de Oliveira Cruz Latorraca C, Mota P, Benavent Caldas Bellotto EF, Martimbianco ALC. Effectiveness and safety of ozone therapy in Dental Caries Treatment: systematic review and Meta-analysis. J Evid-Based Dent Pract. 2020;20(4):101472.
doi: 10.1016/j.jebdp.2020.101472
pubmed: 33303100
Khan U, MacPherson J, Bezuhly M, Hong P. Comparison of Frenotomy techniques for the treatment of Ankyloglossia in children: a systematic review. Otolaryngol Head Neck Surg. 2020;163(3):428–43.
doi: 10.1177/0194599820917619
pubmed: 32482127
Kamber R, Meyer-Lueckel H, Kloukos D, Tennert C, Wierichs RJ. Efficacy of sealants and bonding materials during fixed orthodontic treatment to prevent enamel demineralization: a systematic review and meta-analysis. Sci Rep. 2021;11(1):16556.
doi: 10.1038/s41598-021-95888-6
pubmed: 34400668
pmcid: 8368161
Custódio NB, Costa FS, Cademartori MG, Costa VPP, Goettems ML. Effectiveness of virtual reality glasses as a distraction for children during Dental Care. Pediatr Dent. 2020;42(2):93–102.
pubmed: 32276674
Manchanda S, Sardana D, Yiu CKY. A systematic review and meta-analysis of randomized clinical trials comparing rotary canal instrumentation techniques with manual instrumentation techniques in primary teeth. Int Endod J. 2020;53(3):333–53.
doi: 10.1111/iej.13233
pubmed: 31587323
Xiang B, Wong HM, Perfecto AP, McGrath CPJ. The application of theory-guided oral health interventions in adolescents: a systematic review and meta-analysis of randomized controlled trials. Psychol Health. 2021;36(7):879–94.
doi: 10.1080/08870446.2020.1801679
pubmed: 32755399
Chugh VK, Patnana AK, Chugh A, Kumar P, Wadhwa P, Singh S. Clinical differences of hand and rotary instrumentations during biomechanical preparation in primary teeth-A systematic review and meta-analysis. Int J Paediatr Dent. 2021;31(1):131–42.
doi: 10.1111/ipd.12720
pubmed: 32815216
Taneja S, Singh A, Jain A. Anesthetic effectiveness of Articaine and Lidocaine in Pediatric patients during Dental procedures: a systematic review and Meta-analysis. Pediatr Dent. 2020;42(4):273–81.
pubmed: 32847666
Martins ML, Ribeiro-Lages MB, Masterson D, Magno MB, Cavalcanti YW, Maia LC, Fonseca-Goncalves A. Efficacy of natural antimicrobials derived from phenolic compounds in the control of biofilm in children and adolescents compared to synthetic antimicrobials: a systematic review and meta-analysis. Arch Oral Biol. 2020;118:104844.
doi: 10.1016/j.archoralbio.2020.104844
pubmed: 32736143
Hao S, Ji L, Wang Y. Effect of Honey on Pediatric Radio/Chemotherapy-Induced oral mucositis (R/CIOM): a systematic review and Meta-analysis. Evid-Based Complement Alternat Med; 2022. ID 6906439.
Patnana AK, Chugh VK, Chugh A, Vanga NRV, Kumar P. Effectiveness of zirconia crowns compared with stainless steel crowns in primary posterior teeth rehabilitation: a systematic review and meta-analysis. J Am Dent Assoc. 2022;153(2):158–e166155.
doi: 10.1016/j.adaj.2021.08.005
pubmed: 35086644
Olsson Moller U, Beck I, Ryden L, Malmstrom M. A comprehensive approach to rehabilitation interventions following breast cancer treatment - a systematic review of systematic reviews. BMC Cancer. 2019;19(1):472.
doi: 10.1186/s12885-019-5648-7
pubmed: 31109309
pmcid: 6528312
Matthias K, Rissling O, Pieper D, Morche J, Nocon M, Jacobs A, Wegewitz U, Schirm J, Lorenz RC. The methodological quality of systematic reviews on the treatment of adult major depression needs improvement according to AMSTAR 2: a cross-sectional study. Heliyon. 2020;6(9):e04776.
doi: 10.1016/j.heliyon.2020.e04776
pubmed: 32939412
pmcid: 7479282
Luo J, Chen Z, Liu D, Li H, He S, Zeng L, Yang M, Liu Z, Xiao X, Zhang L. Methodological quality and reporting quality of COVID-19 living systematic review: a cross-sectional study. BMC Med Res Methodol. 2023;23(1):175.
doi: 10.1186/s12874-023-01980-y
pubmed: 37525117
pmcid: 10388517
Gao Y, Cai Y, Yang K, Liu M, Shi S, Chen J, Sun Y, Song F, Zhang J, Tian J. Methodological and reporting quality in non-cochrane systematic review updates could be improved: a comparative study. J Clin Epidemiol. 2020;119:36–46.
doi: 10.1016/j.jclinepi.2019.11.012
pubmed: 31759063
Wasiak J, Shen AY, Tan HB, Mahar R, Kan G, Khoo WR, Faggion CM Jr. Methodological quality assessment of paper-based systematic reviews published in oral health. Clin Oral Investig. 2016;20(3):399–431.
doi: 10.1007/s00784-015-1663-5
pubmed: 26589200
Lasserson TJ, Thomas J, Higgins JPT, Toby J, Lasserson J, Thomas. Julian PT Higgins. In: Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA, editors. Cochrane Handbook for Systematic Reviews of Interventions version 6.4 (updated August 2023). Cochrane, 2023. Chapter 1. www.training.cochrane.org/handbook .
Papageorgiou SN, Dimitraki D, Coolidge T, Kotsanos N. Publication bias & small-study effects in pediatric dentistry meta-analyses. J Evid-Based Dent Pract. 2015;15(1):8–24.
doi: 10.1016/j.jebdp.2014.09.001
pubmed: 25666576
Zhang Y, Akl EA, Schunemann HJ. Using systematic reviews in guideline development: the GRADE approach. Res Synth Methods. 2018;10(3):312–29.
doi: 10.1002/jrsm.1313
Ahn RWA, Abraham A, Saba S, Korenstein D, Madden E, Boscardin WJ, Keyhani S. Financial ties of principal investigators and randomized controlled trial outcomes: cross sectional study. BMJ. 2017;356:i6770.
doi: 10.1136/bmj.i6770
pubmed: 28096109
pmcid: 5241252
Amiri AR, Kanesalingam K, Cro S, Casey AT. Does source of funding and conflict of interest influence the outcome and quality of spinal research? J Spine 2014, 14(2):308–14.
Martins CC, Riva JJ, Firmino RT, Colunga-Lozano LE, Granville-Garcia AF, Zhang Y, Schünemann HJ. Conflict of interest is not associated with positive conclusions in toothpaste trials: a systematic survey. J Clin Epidemiol. 2019;108:140–6.
doi: 10.1016/j.jclinepi.2018.11.026
Bassani R, Pereira GKR, Page MJ, Tricco AC, Moher D, Sarkis-Onofre R. Systematic reviews in dentistry: current status, epidemiological and reporting characteristics. J Dent. 2019;82:71–84.
doi: 10.1016/j.jdent.2019.01.014
pubmed: 30716451
Carrasco-Labra A, Devji T, Qasim A, Phillips MR, Wang Y, Johnston BC, Devasenapathy N, Zeraatkar D, Bhatt M, Jin X, et al. Minimal important difference estimates for patient-reported outcomes: a systematic survey. J Clin Epidemiol. 2021;133:61–71.
doi: 10.1016/j.jclinepi.2020.11.024
pubmed: 33321175
Schunemann HJ, Neumann I, Hultcrantz M, Brignardello-Petersen R, Zeng L, Murad MH, Izcovich A, Morgano GP, Baldeh T, Santesso N, et al. GRADE guidance 35: update on rating imprecision for assessing contextualized certainty of evidence and making decisions. J Clin Epidemiol. 2022;150:225–42.
doi: 10.1016/j.jclinepi.2022.07.015
pubmed: 35934266
Santesso N, Glenton C, Dahm P, Garner P, Akl E, Alper B, Brignardello-Petersen R, Carrasco-Labra A, De Beer H, Hultcrantz M, et al. GRADE guidelines 26: informative statements to communicate the findings of systematic reviews of interventions. J Clin Epidemiol. 2019;S0895–4356(19):30416–30410.