A Systematic Evaluation of the Quality of Meta-analyses in Endodontics

Thammasat University, Bangkok, Thailand.
Journal of endodontics (Impact Factor: 3.38). 04/2010; 36(4):602-8. DOI: 10.1016/j.joen.2009.12.019
Source: PubMed


Meta-analyses have been suggested to be the highest form of evidence available to clinicians to guide clinical practice in dental care. High methodologic quality is a prerequisite for valid interpretation and application of review findings. However, meta-analyses are complex exercises, and assessing quality can be a daunting task. Clinicians and policymakers require guidance, which is not provided adequately by the available literature on the quality of meta-analyses. The purpose of this study was to systematically evaluate the quality of meta-analyses that address topics pertinent to endodontics.
To identify potentially eligible meta-analyses for inclusion, systematic searches performed in MEDLINE and the Cochrane Database of Systematic Reviews were enriched by hand searches, citation mining, and expert recommendation. Comprehensive search strategies were constructed for electronic searches. Predetermined inclusion criteria were applied to each identified meta-analysis independently by two reviewers. To assess report quality, the included meta-analyses were assessed by using A Measurement Tool to Assess Systematic Reviews (AMSTAR).
A total of 16 reports of meta-analyses were included (kappa = 0.96). The overall quality of reports of meta-analyses was found to be high, with an estimated mean overall AMSTAR score of 8.33 out of 11 (95% confidence interval, 7.62-8.88). The weakest areas within the included meta-analyses were failure to report the likelihood of publication bias.
The overall quality of the reports of meta-analyses available in endodontics is high according to AMSTAR.

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    • "The items considered as indicative for review quality are shown in Table 1. Quality rating according to AMSTAR scores has differed in the literature: while some authors regard a score between 8 and 11 as of high, and a score between 4 and 7 of medium review quality [10], others considered an AMSTAR score of 9 -11 as indicative for high and a score of 5 -8 as of moderate quality [11]. However, there appears to be consensus that an AMSTAR score of < 4 signifies low review quality. "
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    • "In addition, a higher preponderance of meta-analysis among Cochrane reviews was also noted. The mean AMSTAR score noted in reviews incorporating meta-analysis (7.93 ± 2.61) was analogous to that obtained in a review of methodological quality of Endodontic meta-analyses, the latter alluding to mean AMSTAR score of 8.33 ( Suebnukarn et al. , 2010 ). "
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