Article type
Abstract
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.
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.