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Review
. 2022 May;55(5):393-404.
doi: 10.1111/iej.13693. Epub 2022 Feb 16.

Methodological assessment and overall confidence in the results of systematic reviews with network meta-analyses in Endodontics

Venkateshbabu Nagendrababu  1 , Clovis M Faggion Jr  2 , Shaju Jacob Pulikkotil  3 , Alaa Alatta  1 , Paul M H Dummer  4
Affiliations
Review

Methodological assessment and overall confidence in the results of systematic reviews with network meta-analyses in Endodontics

Venkateshbabu Nagendrababu et al. Int Endod J. 2022 May.

Abstract

Aim: The aims of the study were to assess the methodological quality of systematic reviews with network meta-analyses (NMAs) in Endodontics using the 'A MeaSurement Tool to Assess systematic Reviews' (AMSTAR 2) tool, and to evaluate the overall confidence in the results of the individual reviews included in the analysis.

Methodology: Systematic reviews with NMAs within the specialty of Endodontics published in English were identified from the PubMed, EbBSCOhost and SCOPUS databases from inception to July 2021. Two reviewers were involved independently in the selection of the reviews, data extraction, methodological quality assessment and overall confidence rating. Disagreements were resolved by discussion between the reviewers to achieve consensus; if disagreements persisted, a third reviewer made the final decision. The methodological quality of the included NMAs was appraised using the AMSTAR 2 checklist, which contains 16 items. The reviewers scored each item-'Yes'-when the item was fully addressed, 'Partial Yes'-when the item was not fully addressed, or 'No'-when the item was not addressed. The overall confidence in the results of each review was classified as 'High', 'Moderate', 'Low' or 'Critically low' based on the criteria reported by the AMSTAR 2 developers.

Results: Twelve systematic reviews with NMAs were included. All the NMAs adequately reported Item 1 ('Did the research questions and inclusion criteria for the review include the components of PICO?'), Item 8 ('Did the review authors describe the included studies in adequate detail?'), Item 9 ('Did the review authors use a satisfactory technique for assessing the risk of bias (RoB) in individual studies that were included in the review?') and Item 16 ('Did the review authors report any potential sources of conflict of interest, including any funding they received for conducting the review?'), whereas only one NMA reported Item 10 adequately ('Did the review authors report on the sources of funding for the studies included in the review?'). The overall confidence in the results of eight reviews was categorized as 'Critically low', one review was 'Low', two reviews were 'Moderate' and one review was 'High'.

Conclusion: The overall confidence in the results for the majority of systematic reviews with NMAs in Endodontics was judged to be 'Critically low' as their methodological quality was below the necessary standard. AMSTAR 2 and PRISMA for NMA guidelines are available to guide authors to produce high-quality systematic reviews with NMAs and for editors and peer-reviewers when assessing submissions to journals.

Keywords: AMSTAR 2; Endodontics; network meta-analyses; systematic reviews.

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References

REFERENCES

    1. Abuabara, K., van Zuuren, E.J. & Flohr, C. (2019) Why does the BJD require registration of systematic reviews and meta-analyses? British Journal of Dermatology, 180, 249-250.
    1. Almeida, M.O., Yamato, T.P., Parreira, P.D., Costa, L.O., Kamper, S. & Saragiotto, B.T. (2020) Overall confidence in the results of systematic reviews on exercise therapy for chronic low back pain: a cross-sectional analysis using the Assessing the Methodological Quality of Systematic Reviews (AMSTAR) 2 tool. Brazilian Journal of Physical Therapy, 24, 103-117.
    1. Almuthhin, M., Afify, M., Alshammari, Y., Alkatheeri, N., Altuwaijri, S.M., Alhussain, B. et al. (2020) The safety and efficacy of pre-and post-medication for postoperative endodontic pain: a systematic review and network meta-analysis. The Open Dentistry Journal, 14, 563-599.
    1. Buti, J., Glenny, A.M., Worthington, H.V., Nieri, M. & Baccini, M. (2011) Network meta-analysis of randomised controlled trials: direct and indirect treatment comparisons. European Journal of Oral Implantology, 4, 55-62.
    1. Carrasco-Labra, A., Brignardello-Petersen, R., Glick, M., Guyatt, G.H. & Azarpazhooh, A. (2015) A practical approach to evidence-based dentistry: VI: how to use a systematic review. Journal of the American Dental Association, 146, 255-265.