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Abstract：
BACKGROUND: To assess the reporting of the certainty of the evidence using the GRADE approach in systematic reviews of interventions in pediatric dentistry.
METHODS: The inclusion criteria were systematic reviews of randomized clinical trials (RCTs) and non-randomized studies of interventions (NRSIs) in pediatric dentistry that reported the certainty of the evidence through the GRADE approach. Paired independent reviewers screened the studies, extracted data, and appraised the methodological quality using the Assessing the Methodological Quality of Systematic Reviews (AMSTAR 2) tool. The certainty of the evidence was extracted for each outcome. A descriptive analysis was conducted.
RESULTS: Around 28% of pediatric dentistry reviews of interventions used the GRADE approach (n = 24). Twenty reviews reported 112 evidence outcomes from RCTs and 13 from NRSIs using GRADE evidence profile tables. The methodological quality was high (16.7%), moderate (12.5%), low (37.5%), and critically low (33.3%), fulfilling the majority of the AMSTAR 2 criteria. The certainty of the evidence for outcomes generated from RCTs and NRSIs was very low (40.2% and 84.6%), low (33.1% and 7.7%), moderate (17.8% and 7.7%), and high (9.8% and 0.0%). The main reasons to downgrade the certainty were due to (for RCTs and NRSIs, respectively): risk of bias (68.8% and 84.6%), imprecision (67.8% and 100.0%), inconsistency (18.8% and 23.1%), indirectness (17.8% and 0.0%), and publication bias (7.1% and 0.0%).
CONCLUSIONS: The proportion of systematic reviews assessing the certainty of the evidence using the GRADE approach was considered small, considering the total initial number of published pediatric dentistry reviews of intervention. The certainty of the evidence was mainly very low and low, and the main problems for downgrading the certainty of evidence were due to risk of bias and imprecision.
BACKGROUND: PROSPERO database #CRD42022365443.
METHODS: The inclusion criteria were systematic reviews of randomized clinical trials (RCTs) and non-randomized studies of interventions (NRSIs) in pediatric dentistry that reported the certainty of the evidence through the GRADE approach. Paired independent reviewers screened the studies, extracted data, and appraised the methodological quality using the Assessing the Methodological Quality of Systematic Reviews (AMSTAR 2) tool. The certainty of the evidence was extracted for each outcome. A descriptive analysis was conducted.
RESULTS: Around 28% of pediatric dentistry reviews of interventions used the GRADE approach (n = 24). Twenty reviews reported 112 evidence outcomes from RCTs and 13 from NRSIs using GRADE evidence profile tables. The methodological quality was high (16.7%), moderate (12.5%), low (37.5%), and critically low (33.3%), fulfilling the majority of the AMSTAR 2 criteria. The certainty of the evidence for outcomes generated from RCTs and NRSIs was very low (40.2% and 84.6%), low (33.1% and 7.7%), moderate (17.8% and 7.7%), and high (9.8% and 0.0%). The main reasons to downgrade the certainty were due to (for RCTs and NRSIs, respectively): risk of bias (68.8% and 84.6%), imprecision (67.8% and 100.0%), inconsistency (18.8% and 23.1%), indirectness (17.8% and 0.0%), and publication bias (7.1% and 0.0%).
CONCLUSIONS: The proportion of systematic reviews assessing the certainty of the evidence using the GRADE approach was considered small, considering the total initial number of published pediatric dentistry reviews of intervention. The certainty of the evidence was mainly very low and low, and the main problems for downgrading the certainty of evidence were due to risk of bias and imprecision.
BACKGROUND: PROSPERO database #CRD42022365443.
摘要：
背景：在儿科牙科干预的系统评价中使用GRADE方法评估证据的确定性报告。
方法：纳入标准是对儿科牙科的随机临床试验（RCT）和非随机干预研究（NRSIs）的系统评价，报告了通过GRADE方法获得的证据的确定性。配对的独立审稿人筛选了这些研究，提取的数据，并使用评估系统审查方法质量（AMSTAR2）工具评估方法质量。为每个结果提取证据的确定性。进行了描述性分析。
结果：约28%的儿科牙科干预措施评价使用GRADE方法（n=24）。使用GRADE证据概况表，20条评论报告了来自RCT的112项证据结果和来自NRSIs的13项证据结果。方法学质量高(16.7%),中等(12.5%)，低（37.5%），和极低(33.3%)，符合AMSTAR2的大部分标准。RCT和NRSIs产生的结果证据的确定性非常低（40.2%和84.6%），低(33.1%和7.7%)，中等(17.8%和7.7%)，和高（9.8%和0.0%）。降低确定性的主要原因是(对于RCT和NRSIs，分别）：偏倚风险（68.8%和84.6%），不精确(67.8%和100.0%)，不一致(18.8%和23.1%)，间接性(17.8%和0.0%)，和发表偏倚（7.1%和0.0%）。
结论：使用GRADE方法评估证据确定性的系统评价的比例被认为很小，考虑已发表的儿科牙科干预评论的初始总数。证据的确定性主要是很低很低,降低证据确定性的主要问题是由于偏见和不精确的风险。
背景：PROSPERO数据库#CRD42022365443。
方法：纳入标准是对儿科牙科的随机临床试验（RCT）和非随机干预研究（NRSIs）的系统评价，报告了通过GRADE方法获得的证据的确定性。配对的独立审稿人筛选了这些研究，提取的数据，并使用评估系统审查方法质量（AMSTAR2）工具评估方法质量。为每个结果提取证据的确定性。进行了描述性分析。
结果：约28%的儿科牙科干预措施评价使用GRADE方法（n=24）。使用GRADE证据概况表，20条评论报告了来自RCT的112项证据结果和来自NRSIs的13项证据结果。方法学质量高(16.7%),中等(12.5%)，低（37.5%），和极低(33.3%)，符合AMSTAR2的大部分标准。RCT和NRSIs产生的结果证据的确定性非常低（40.2%和84.6%），低(33.1%和7.7%)，中等(17.8%和7.7%)，和高（9.8%和0.0%）。降低确定性的主要原因是(对于RCT和NRSIs，分别）：偏倚风险（68.8%和84.6%），不精确(67.8%和100.0%)，不一致(18.8%和23.1%)，间接性(17.8%和0.0%)，和发表偏倚（7.1%和0.0%）。
结论：使用GRADE方法评估证据确定性的系统评价的比例被认为很小，考虑已发表的儿科牙科干预评论的初始总数。证据的确定性主要是很低很低,降低证据确定性的主要问题是由于偏见和不精确的风险。
背景：PROSPERO数据库#CRD42022365443。
