Deconstructing evidence in orthodontics: making sense of systematic reviews, randomized clinical trials, and meta-analyses.
Much has been written in support of systematic reviews and the randomized clinical trials and meta-analyses upon which they are based. Clearly, the medical profession (as opposed to the dental profession) has been the leader in publishing the benefits of systematic reviews over the traditional, qualitative narrative reviews. At the same time, the medical profession also appears to be ahead of the dental profession in recognizing the limitations of such reviews. That said, there are a number of inherent problems with systematic reviews, as well as the randomized clinical trials and meta-analyses that back them up. To better facilitate evidence-based decision making, this article discusses the shortcomings of systematic reviews so that practitioners are fully aware of their drawbacks, as well as their benefits.
Department of Orthodontics and Dentofacial Orthopedics, University of Pittsburgh School of Dental Medicine, Pittsburgh, Pennsylvania, USA.
Donald J
DJ
Rinchuse
Daniel J
DJ
Rinchuse
Sanjivan
S
Kandasamy
Marc B
MB
Ackerman
D015982:Bias; D003657:Decision Making; D019317:Evidence-Based Medicine; D006801:Humans; D015201:Meta-Analysis as Topic; D009970:Orthodontics; D016032:Randomized Controlled Trials as Topic / Q000379:methods / Q000592:standards; D015203:Reproducibility of Results; D012107:Research Design / Q000592:standards; D012196:Review Literature as Topic