Abstract
Systematic reviews are intended to collate and analyze the evidence regarding a specific aspect of clinical practice in a drive for evidence-based health care. 1 Sackett D.L. Rosenberg W.M.C. Gray J.A.M. Haynes R.B. Richardson W.S. Evidence based medicine: what it is and what it isn’t?. BMJ. 1996; 312: 71-72 Crossref PubMed Google Scholar Unfortunately, many systematic reviews in medicine and dentistry 2 Glenny A.M. Esposito M. Coulthard P. Worthington H.V. The assessment of systematic reviews in dentistry. Eur J Oral Sci. 2003; 111: 85-92 Crossref PubMed Scopus (98) Google Scholar ,3 Bassani R. Pereira G.K.R. Page M.J. Tricco A.C. Moher D. Sarkis-Onofre R. Systematic reviews in dentistry: current status, epidemiological and reporting characteristics. J Dent. 2019; 82: 71-84 Crossref PubMed Scopus (23) Google Scholar conclude by stating that further evidence is required through well-designed randomized clinical trials. 4 Fleming P.S. Seehra J. Polychronopoulou A. Fedorowicz Z. Pandis N. A PRISMA assessment of the reporting quality of systematic reviews in orthodontics. Angle Orthod. 2013; 83: 158-163 Crossref PubMed Scopus (75) Google Scholar , 5 Pandis N. Fleming P.S. Worthington H. Salanti G. The quality of the evidence according to GRADE is predominantly low or very low in oral health systematic reviews. PLoS One. 2015; 10e0131644 Crossref Scopus (18) Google Scholar , 6 Littlewood S.J. Millett D.T. Doubleday B. Bearn D.R. Worthington H.V. Retention procedures for stabilising tooth position after treatment with orthodontic braces. Cochrane Database Syst Rev. 2016; 2016: CD002283 Google Scholar It has been mooted that within orthodontics, systematic reviews considerably outweigh the number of clinical trials 7 Papageorgiou S.N. Eliades T. Evidence-based orthodontics: too many systematic reviews, too few trials. J Orthod. 2019; 46: 9-12 Crossref PubMed Scopus (18) Google Scholar with evidence that a substantial proportion of the former is limited or inconclusive. In many cases, this is due to too low-quality studies preventing or limiting meta-analyses. 8 Koletsi D. Fleming P.S. Eliades T. Pandis N. The evidence from systematic reviews and meta-analyses published in orthodontic literature. Where do we stand?. Eur J Orthod. 2015; 37: 603-609 Crossref PubMed Scopus (24) Google Scholar When several systematic reviews exist on a topic, it is possible to evaluate and collate their findings in an overview or umbrella review. 9 Lewis R. Hendry M. Din N. Stanciu M.A. Nafees S. Hendry A. et al. Pragmatic methods for reviewing exceptionally large bodies of evidence: systematic mapping review and overview of systematic reviews using lung cancer survival as an exemplar. Syst Rev. 2019; 8: 171 Crossref PubMed Scopus (5) Google Scholar However, considerable duplication and unnecessary overlap have been identified within overviews, representing significant research waste. 10 Lunny, C, Reid, EK, Neelakant, T, Chen A, Zhang JH, Shinger G, et al. A new taxonomy was developed for overlap across ‘overviews of systematic reviews’: a meta-research study of research waste. Res Syn Meth. Epub 2021 Dec 19. Google Scholar
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