Department of Orthodontics, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, Kings College Hospital NHS Foundation Trust, London, UK.
Department of Orthodontics and Dentofacial Orthopedics, Dental School/Medical Faculty, University of Bern, Bern, Switzerland.
Eur J Orthod. 2021 Oct 4;43(5):544-550. doi: 10.1093/ejo/cjaa074.
This study aimed to compare the methodological quality and risk bias of orthodontic systematic reviews (SRs) using the AMSTAR (Assessing the Methodological Quality of Systematic Reviews) and ROBIS (Risk of Bias in Systematic Review) tools.
A search of electronic databases (OVID and Medline) was undertaken to identify orthodontic SRs published in five primary orthodontic journals (January 2015 to December 2018) and the Cochrane Library of Systematic Reviews (January 2000 to January 2018). Full articles were reviewed by two assessors against the eligibility criteria. Methodological quality of each SR was gauged using the AMSTAR tool with a score of 0 or 1 given for each of the 11 items. Cumulative totals were calculated and scores between 4 and 8 represented poor to fair methodological quality and 9 or greater deemed to be good. As per the ROBIS tool, the risk of bias (ROB) for each domain was assessed and the overall ROB was classified as low, high, or unclear.
A total of 91 SRs were included. The median AMSTAR score was 8 (IQR = 3). The methodological quality of 47.3% SRs was rated good. SRs without protocol registration (Coef: -3.00, 95% CI: -3.72, -2.28, P < 0.001) and American continent SRs (Coef: -1.00, 95% CI: -1.72, -0.21, P = 0.007) were associated with lower AMSTAR scores. A total of 56.0% SRs were rated a low ROB, with a lower ROB apparent in multicentre SRs (OR: 0.27, 95% CI: 0.11, 0.64, P = 0.003) and a higher ROB evident in SRs without a registered protocol (OR: 111.81, 95% CI: 22.34, 559.62, P < 0.001). When adjusted for the effect of AMSTAR score on ROB, a higher ROB was associated with SRs without protocol registration (OR: 32.24, 95% CI: 6.03, 172.44, P ≤ 0.001). As the AMSTAR score (per unit) increased, the odds of having a high ROB rating decreased (OR: 0.31, 95% CI: 0.21, 0.45, P ≤ 0.001).
As the methodological quality rating of orthodontic SRs increases, a reduction in the ROB is evident.
本研究旨在使用 AMSTAR（评估系统评价方法学质量）和 ROBIS（系统评价偏倚风险）工具比较正畸系统评价（SRs）的方法学质量和偏倚风险。
对 5 种主要正畸期刊（2015 年 1 月至 2018 年 12 月）和 Cochrane 系统评价图书馆（2000 年 1 月至 2018 年 1 月）发表的正畸 SRs 进行电子数据库（OVID 和 Medline）检索。两名评估员根据入选标准对全文进行评估。使用 AMSTAR 工具评估每个 SR 的方法学质量，每个 11 项中的每一项得 0 或 1 分。计算累积总分，得分在 4 至 8 分之间表示方法学质量差到中等，9 分或以上表示方法学质量良好。根据 ROBIS 工具，对每个领域的偏倚风险（ROB）进行评估，并将总体 ROB 分类为低、高或不清楚。
共纳入 91 项 SR。AMSTAR 评分中位数为 8（IQR=3）。47.3%的 SR 方法学质量评为良好。没有方案登记（系数：-3.00，95%CI：-3.72，-2.28，P<0.001）和来自美洲大陆的 SR（系数：-1.00，95%CI：-1.72，-0.21，P=0.007）的 AMSTAR 评分较低。共有 56.0%的 SR 被评为低 ROB，多中心 SR 的 ROB 较低（OR：0.27，95%CI：0.11，0.64，P=0.003），没有方案登记的 SR 的 ROB 较高（OR：111.81，95%CI：22.34，559.62，P<0.001）。当调整 AMSTAR 评分对 ROB 的影响时，没有方案登记的 SR 与较高的 ROB 相关（OR：32.24，95%CI：6.03，172.44，P<0.001）。随着 AMSTAR 评分（单位）的增加，高 ROB 评分的可能性降低（OR：0.31，95%CI：0.21，0.45，P<0.001）。
随着正畸 SR 方法学质量评分的提高，ROB 降低。
