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

Abstract

<title>Abstract</title> <bold>Objectives:</bold> To assess how systematic reviews of interventions in dentistry report the certainty of evidence using the Grading of Recommendations, Assessment, Development, Evaluation approach (GRADE). <bold>Methods: </bold>A search on MEDLINE/PubMed database from September 2019 to September 2020 was performed. We included systematic reviews of intervention in dentistry using the GRADE approach to assess the certainty of the evidence. Data was narratively synthesized and summarized using relative frequencies. <bold>Results:</bold> From 449 retrieved systematic reviews 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. For the remaining reviews (50.9%), the main outcome was not possible to be identified, and in 7.5% the judgement about the certainty of evidence found was not adequately reported. Finally, 59.4% of systematic reviews used the certainty of evidence assessment to support their conclusion. <bold>Conclusions:</bold> Only around one in four systematic reviewsof 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.

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