Evidence in dentistry guidelines

Abstract

CONTEXT AND OBJECTIVE: Guidelines are suggestions for clinical practice based on the best available scientific evidence. Nevertheless, in drafting such guidelines, existing systematic reviews are often ignored and are replaced by general consensuses. This ends up compromising the quality of the instructions through bias. Our objective was to investigate whether Cochrane systematic reviews were present among the bibliographic references of prevention and treatment guidelines for dentistry that have been published in databases. DESIGN AND SETTING:This retrospective, observational study was conducted at the Brazilian Cochrane Center. METhODS:The databases were searched for guidelines. Any guidelines obtained were then checked to find whether Cochrane systematic reviews were present in the bibliographic references of the guidelines. In their absence, we checked whether such reviews had not been included because no reviews existed yet, or because such reviews had not been consulted despite already existing.RESULTS: 223 studies were initially selected; of these, 77 were excluded. Of the 146 guidelines included, 46 could have made reference to existing systematic reviews, but only 13 studies did so. Among these 13 studies, eight were systematic reviews following Cochrane methodology. Thirty-three guidelines had not been drafted using published systematic reviews as references, and 100 guidelines had been unable to use Cochrane references because no reviews existed yet. CONCLUSION:It is necessary to increase awareness of the importance of using systematic reviews in drafting dentistry guidelines. Likewise, it is necessary to develop systematic reviews that answer questions on the various topics that remain unanswered.RESUMO CONTEXTO E OBJETIVO: Diretrizes são sugestões de condutas clínicas baseadas nas melhores evidências científicas disponíveis. No entanto, muitas vezes, para a construção da diretriz, as revisões sistemáticas existentes são desconsideradas e substituídas por consensos, o que acaba comprometendo a qualidade das suas instruções por serem enviesadas. O objetivo foi verificar a presença das revisões sistemáticas Cochrane nas referências bibliográficas das diretrizes de prevenção e tratamento na odontologia publicados nas bases de dados. LOCAL E TIPO DE ESTUDO: Estudo retrospectivo observacional, conduzido no Centro Cochrane do Brasil.MéTODOS: Busca das diretrizes foi realizada nas bases de dados. A partir da obtenção delas, foram checadas a existência de revisões sistemáticas Cochrane nas suas referências bibliográficas. Na sua ausência, era verificada se a revisão sistemática não foi incluída porque ainda não existe ou porque, existindo, não foi consultada. RESULTADOS:Foram previamente selecionados 223 estudos, e destes, 77 foram excluídos. Das 146 diretrizes incluídas, 46 poderiam incluir em suas referências as revisões sistemáticas existentes, mas apenas 13 estudos o fizeram, dentre eles somente 8 eram revisões sistemáticas com metodologia Cochrane. Trinta e três diretrizes não usaram para a sua...

Dentists’ attitudes and practices toward evidence-based dentistry: a systematic review

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