Reporting of the certainty of evidence through GRADE in systematic reviews in dentistry indexed during late 2019 - late 2020

Poster
2024 Prague [Global Evidence Summit]
Oliveira J1, Oliveira L2, Pereira R3, Polmann H1, Pauletto P4, Stefani C5, Stefani C6, Massignan C5, Martins-Pfeifer C7, Porfírio G8, Porfírio G9, Peres M10, Peres M11, Flores-Mir C6, De Luca Canto G1
1Federal University Of Santa Catarina, Florianópolis, Santa Catarina, Brazil
2São Leopoldo Mandic Institute and Research Center, Campinas, São Paulo, Brazil
3Universidade de São Paulo, São Paulo, São Paulo, Brazil
4Universidad de las Americas, Quito, Ecuador
5University of Brasília, Brasília, Distrito Federal, Brazil
6University of Alberta, Edmonton, Canada
7Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
8São Judas Tadeu University, São Caetano do Sul, São Paulo, Brazil
9Municipal University of São Caetano do Sul, São Caetano do Sul, São Paulo, Brazil
10National Dental Research Institute Singapore, Singapore
11Duke-NUS Medical School, Singapore

Background:

The confidence in the final estimate in systematic reviews (SRs), known as the certainty of evidence, relies on the scientific and methodological rigor applied to summarize outcomes. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was developed to standardize this assessment, considering domains like risk of bias, inconsistency, indirectness, imprecision, and publication bias. Despite the increasing number of SRs in dentistry, the utilization of the GRADE approach remains limited, particularly in SRs evaluating interventions, highlighting the need for further examination of its application in this field.

Objectives:

To assess how SRs of interventions in dentistry report the certainty of evidence using the GRADE approach.

Methods:

A search on MEDLINE/PubMed database from September 2019 to September 2020 was performed. We included SRs of intervention in dentistry using the GRADE approach to assess the certainty of the evidence. Data was narratively synthesized and summarized using relative frequencies.

Results:

From 449 retrieved SRs of interventions in dentistry, 23.6% used the GRADE approach and were finally included. Among these, 92.5% used the approach as recommended by the GRADE developers. Regarding the GRADE individual components, 73.6% of studies reported how the risk of bias, 61.3% inconsistency, 16% indirectness, 41.5% imprecision, and 48.1% publication bias domains were assessed. Overall, 41.5% of reviews clearly stated the main outcome assessed and, from these, 6.8% reported high, 38.6% moderate, 25% low, and 29.5% very low certainty of the evidence. It was not possible to identify the outcome in nearly 51% of reviews, and among them, in 7.5% the judgment of the certainty of the evidence was not transparerently reported. Finally, 59.4% of SRs used the certainty of evidence assessment to support their conclusion.

Conclusions:

Only around one in four SRs of interventions in dentistry identified in this study have used the GRADE approach to assess the certainty of evidence. In most of those reviews that applied it, GRADE was correctly applied. In more than half, the certainty of the evidence was judged to be low or very low.