A Critical Appraisal of Systematic Review Methodologies in Health Policy

Objectives: This review evaluates the methodologies and search strategies in NHMRC systematic reviews on the effects of water fluoridation on dental and broader health outcomes, comparing them with Cochrane’s internationally recognised standards. Study Design: A critical review of the search strategies, inclusion criteria, and methodologies used to assess water fluoridation’s health impacts. Methods: The review analyses the search strategies for dental caries and broader health effects, comparing search dates, syntax, and comprehensiveness. It also evaluates methodological standards, including protocols, reporting transparency, and the inclusion of certain health outcomes. Results: Significant inconsistencies were found, including outdated search dates, varying search syntax, and a lack of differentiation between fluoridation agents. Exclusion of health outcomes like dental fluorosis raises concerns about objectivity and completeness. Conclusions: The review highlights the need for standardised protocols, transparent reporting, and updated search strategies to ensure comprehensive, unbiased findings. Addressing these gaps will improve the quality of future reviews and inform more equitable public health decisions.