Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Critical appraisal of systematic reviews of intervention in dentistry published between 2019-2020 using the AMSTAR 2 tool

Abstract

Introduction The number of systematic reviews (SRs) in dentistry published each year has grown considerably, and they have been essential in clinical decision-making and health policy.

Objective The objective is to critically appraise SRs of intervention in dentistry using the 'A Measurement Tool to Assess Systematic Reviews 2' (AMSTAR 2) tool published within one year.

Methods A search in the Medline/PubMed database was performed. The SRs were identified in two phases. The first phase identified SRs of interventions in dentistry by title and abstract. In the second phase, the full text was read, applying the eligibility criteria. Three calibrated reviewers methodologically assessed all SRs identified using the AMSTAR 2 tool. Data were analysed descriptively, and SRs were grouped according to methodological quality as moderate/high and low/critically low. A logistic regression model was applied to explore the associations between methodological quality and the study's characteristics.

Results Two hundred and twenty-two SRs were included. The methodological quality of the SRs included in this study were: critically low (56.8%), low (27.9%), moderate (14.4%) and high (0.9%), according to AMSTAR 2. There were no statistical differences between moderate/high and low/critically low methodological quality and publication year, continent, journal Impact Factor and dental speciality.

Conclusion Less than 1% of recently published SRs in dentistry were classified with high methodological quality. We hope that this study will alert researchers about the need to improve the methodological quality of SRs.

This is a preview of subscription content, access via your institution

Access options

Buy article

Get time limited or full article access on ReadCube.

$32.00

All prices are NET prices.

Fig. 1
Fig. 2

References

  1. Sackett D L, Rosenberg W M C, Grey J A M, Haynes R B, Richardson W S. Evidence based medicine: what it is and what it isn't. BMJ 1996; 312: 71-72.

  2. Sackett D L, Straus S E, Richardson W S, Rosenberg W H R. Evidence-based medicine: How to practice and teach EBM. 2nd ed. New York: Churchill Livingstone, 2000.

  3. Bhargava K, Bhargava D. Evidence Based Health Care A scientific approach to health care. Sultan Qaboos Univ Med J 2007; 7: 105-107.

  4. Cook D J, Mulrow C D, Haynes R B. Systematic reviews: synthesis of best evidence for clinical decisions. Ann Intern Med 1997; 126: 376-380.

  5. Gopalakrishnan S, Ganeshkumar P. Systematic reviews and meta-analysis: understanding the best evidence in primary healthcare. J Fam Med Prim Care 2013; 2: 9.

  6. Page M J, McKenzie J E, Bossuyt P M et al. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ 2021; DOI: 10.1136/bmj.n71.

  7. Campbell M, Mckenzie J E, Sowden A et al. Synthesis without meta-analysis (SWiM) in systematic reviews: reporting guideline. BMJ 2020; DOI: 10.1136/bmj.l6890.

  8. Shea B J, Reeves B C, Wells G et al. AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ 2017; DOI: 10.1136/bmj.j4008.

  9. Bassani R, Pereira G K R, Page M J, Tricco A C, Moher D, Sarkis-Onofre R. Systematic reviews in dentistry: Current status, epidemiological and reporting characteristics. J Dent 2019; 82: 71-84.

  10. Saltaji H, Cummings G G, Armijo-Olivo S et al. A descriptive analysis of oral health systematic reviews published 1991-2012: cross sectional study. PLoS One 2013; DOI: 10.1371/journal.pone.0074545.

  11. Chugh A, Kumar A, Kumar P, Kumar V, Khera D. Journal of Oral Biology and Craniofacial Research Critical analysis of methodological quality of systematic reviews and meta-analysis of antibiotics in third molar surgeries using AMSTAR 2. J Oral Biol Craniofac Res 2020; 10: 441-449.

  12. Meza M J, Miranda T S, Almeida M L, Silva H D, Figueiredo L C, Duarte P M. An umbrella review on the effects of diabetes on implant failure and peri-implant diseases. Braz Oral Res 2019; DOI: 10.1590/1807-3107bor-2019.vol33.0070.

  13. Souto-Maior J R, Pellizzer E P, de Luna Gomes J M et al. Influence of diabetes on the survival rate and marginal bone loss of dental implants: an overview of systematic reviews. J Oral Implantol 2019; 45: 334-340.

  14. Higgins J, Thomas J, Chandler J et al. Cochrane Handbook for Systematic Reviews of Interventions. 2020. Available at https://training.cochrane.org/handbook/current (accessed October 2021).

  15. American Dental Association. American Dental Association - Dental Specialties. 2020. Available at https://www.ada.org/en/ncrdscb/dental-specialties/speciality-definitions (accessed October 2021).

  16. Saltaji H, Ospina M B, Armijo-Olivo S et al. Evaluation of risk of bias assessment of trials in systematic reviews of oral health interventions, 1991-2014: A methodology study. J Am Dent Assoc 2016; DOI: 10.1016/j.adaj.2016.03.017.

  17. Schardt C, Adams M B, Owens T, Keitz S, Fontelo P. Utilization of the PICO framework to improve searching PubMed for clinical questions. BMC Med Inf Decis Mak 2007; 7: 16.

  18. Richardson W S, Wilson M C, Nishikawa J, Hayward R S. The well-built clinical question: a key to evidence-based decisions. ACP J Club 1995; 123: A12-A13.

  19. Booth A, O'Rourke A J, Ford N J. Structuring the pre-search reference interview: a useful technique for handling clinical questions. Bull Med Libr Assoc 2000; 88: 239.

  20. Booth A, Clarke M, Ghersi D, Moher D, Petticrew M, Stewart L. An international registry of systematic-review protocols. Lancet 2011; 377: 108-109.

  21. Silagy C A, Middleton P, Hopewell S. Publishing protocols of systematic reviews: comparing what was done to what was planned. JAMA 2002; 287: 2831-2834.

  22. Mahood Q, Van Eerd D, Irvin E. Searching for grey literature for systematic reviews: challenges and benefits. Res Synth Methods 2014; 5: 221-234.

  23. Hopewell S, McDonald S, Clarke M J, Egger M. Grey literature in meta-analyses of randomized trials of health care interventions. Cochrane Database Syst Rev 2007; DOI: 10.1002/14651858.MR000010.pub3.

  24. McAuley L, Tugwell P, Moher D. Does the inclusion of grey literature influence estimates of intervention effectiveness reported in meta-analyses? Lancet 2000; 356: 1228-1231.

  25. Bellefontaine S P, Lee C M. Between black and white: Examining grey literature in meta-analyses of psychological research. J Child Fam Stud 2014; 23: 1378-1388.

  26. Greenhalgh T, Peacock R. Effectiveness and efficiency of search methods in systematic reviews of complex evidence: audit of primary sources. BMJ 2005; 331: 1064-1065.

  27. Muka T, Glisic M, Milic J, Verhoog S, Bohlius J, Bramer W. A 24-step guide on how to design, conduct, and successfully publish a systematic review and meta - analysis in medical research. Eur J Epidemiol 2020; 35: 49-60.

  28. Tawfik G M, Agus K, Dila S, Yousif M, Mohamed F. A step by step guide for conducting a systematic review and meta-analysis with simulation data. Trop Med Health 2019; DOI: 10.1186/s41182-019-0165-6.

  29. Higgins J P T, Altman D G, Gøtzsche P C, Jüni P, Moher D, Oxman A D. The Cochrane Collaboration's tool for assessing risk of bias in randomised trials. BMJ 2011; DOI: 10.1136/bmj.d5928.

  30. Higgins J P T, Thompson S G, Deeks J J, Altman D G. Measuring inconsistency in meta-analyses. BMJ 2003; 327: 557-560.

  31. Patsopoulos N. Reasons or excuses for avoiding meta-analysis in forest plots. BMJ 2008; 336: 1413-1415.

  32. Ayorinde A A, Williams I, Mannion R et al. Assessment of publication bias and outcome reporting bias in systematic reviews of health services and delivery research: A meta-epidemiological study. PLoS One 2020; DOI: 10.1371/journal.pone.0227580.

  33. Lexchin J, Bero L A, Djulbegovic B, Clark O. Pharmaceutical industry sponsorship and research outcome and quality: systematic review. BMJ 2003; 326: 1167-1170.

  34. Moustafa K. The Disaster of the Impact Factor. Sci Eng Ethics 2015; 21: 139-142.

  35. Soares R C, da Rosa S V, Moysés S T et al. Methods for prevention of early childhood caries: Overview of systematic reviews. Int J Paediatr Dent 2021; 31: 394-421.

  36. Bucci R, Montanaro D, Rongo R, Valletta R, Michelotti A, D'Antò V. Effects of maxillary expansion on the upper airways: Evidence from systematic reviews and meta-analyses. J Oral Rehabil 2019; 46: 377-387.

  37. Taylor H L, Rahurkar S, Treat T J, Thyvalikakath T P, Schleyer T K. Does Nonsurgical Periodontal Treatment Improve Systemic Health? J Dent Res 2021; 100: 253-260.

Download references

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Patrícia Pauletto, Helena Polmann and Júlia Meller Dias de Oliveira are supported by CAPES (Coordination for the Improvement of Higher Education Personnel), Ministry of Education, Brazil.

Author information

Authors and Affiliations

Authors

Contributions

The authors declare that they have read and approved the final version of this manuscript. MSc Patrícia Pauletto worked on study conceptualisation, design, data collection, data analysis, drafted the initial manuscript, and approved the final manuscript as submitted. MSc Helena Polmann worked on study conceptualisation, design, data collection and approved the final manuscript as submitted. MSc Jessica Conti Réus worked on study conceptualisation, design, data collection and approved the final manuscript as submitted. MSc Julia Meller Dias de Oliveira worked on study conceptualisation, design, data collection, data analysis and approved the final manuscript as submitted. MSc Débora Chaves worked on study conceptualisation, design, data collection and approved the final manuscript as submitted. MSc Karyn Lehmkuhl worked on study conceptualisation, design, data analysis, drafted the initial manuscript and approved the final manuscript as submitted. Dr Carla Massignan worked on study conceptualisation, design, data analysis, critically reviewed the manuscript and approved the final manuscript as submitted. Dr Cristine Miron Stefani worked on study conceptualisation, design, data analysis, and critically reviewed the manuscript and approved the final manuscript as submitted. Dr Carolina Castro Martins worked on study conceptualisation and data analysis, critically reviewed the manuscript and approved the final manuscript as submitted. Dr Carlos Flores-Mir worked on study conceptualisation and data analysis, critically reviewed the manuscript and approved the final manuscript as submitted. Dr Graziela De Luca Canto worked on study conceptualisation, data analysis and critically reviewed the manuscript, and approved the final manuscript as submitted.

Corresponding author

Correspondence to Patrícia Pauletto.

Ethics declarations

The authors have no conflict of interest to report. The protocol of this study was registered in the Open Science Frameworks under identifier: DOI 10.17605/OSF.IO/GPKST.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Pauletto, P., Polmann, H., Réus, J. et al. Critical appraisal of systematic reviews of intervention in dentistry published between 2019-2020 using the AMSTAR 2 tool. Evid Based Dent (2022). https://doi.org/10.1038/s41432-022-0802-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1038/s41432-022-0802-5

This article is cited by

Search

Quick links