Avaliação do risco de viés de estudos in vitro em endodontia: uma revisão guarda-chuva

Abstract

Several criteria without established standards have been reported to assess the risk of fias (RoB) in systematic reviews (SRs) of in vitro studies in the endodontic literature.hese SRs often use criteria adapted from previous reviews, including SRs from clinical trials, to adjust for the complexity of different factors that can be characterized as bias. The aim of this study was to carry out an umbrella review of the RoB tools used in SRs of in vitro studies published in the endodontic area and to synthesize common criteria used, as well as to propose a new RoB tool for in vitro studies in endodontics. Inclusion criteria were SRs from in vitro studies focusing on endodontics with RoB evaluated. Five databases were searched (PubMed, Embase, Web of Science, Scopus and Cochrane Library) and data were extracted independently by two reviewers. Common criteria used to assess RoB were pooled and analyzed to formulate a new tool: RoBEndo. Three examiners used the RoBEndo tool and the RoBDEMAT to analyze 9 in vitro studies in the scope of endodontics. The agreement between them was assessed using Cohen's Kappa statistics in the IBM SPSS Statistics software (SPSS Inc., Chicago, IL, USA). The electronic search identified 6,418 potentially relevant records and 87 SRs were included. All SRs assessed RoB with criteria adapted from other reviews or by adapting existing tools. The Cochrane Collaboration Tools was the most cited tool to assess RoB (19.5%). Fourteen items were selected for the elaboration of the RoBEndo tool, grouped into 5 main domains. Substantial and near-perfect agreement was found between examiners using RoBEndo. A large divergence was found in the criteria used to assess RoB from in vitro endodontic studies. Based on all reviews, it was possible to develop a new RoB tool (RoBEndo) with high inter-rater agreement.