Evaluation of the Use of GRADE in Dentistry Systematic Reviews and its Impact on Conclusions: A Protocol for a Methodological Study

Abstract Background: There is a growing body of evidence of systematic reviews (SRs) with varying degrees of methodological quality. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach allows SR authors to assess the certainty of the evidence they found and transparently relay their conclusions. As there appears to be infrequent utilization of GRADE in the field of dentistry, to identify the impact of GRADE, the aim of this study is to evaluate the use of GRADE in the dental literature and determine whether SRs that use GRADE differ from those that do not with respect to their conclusions.Methods/Design: We will search Ovid MEDLINE for SRs published from 2016 to the present. We will conduct both screening and data extraction independently and in duplicate and use pre-piloted, standardized forms for data extraction. We will determine the frequency of the use of GRADE and the varying levels of certainty in the current literature and evaluate whether GRADE is being used appropriately. We will also evaluate whether SRs not using GRADE differ from those that use GRADE with regards to methodological quality. We will also determine whether the conclusions of SRs that do not use GRADE would change had GRADE been utilized. Additionally, we will evaluate whether SRs using GRADE are more likely to formulate appropriate conclusions compared to SRs that do not use it.Discussion: This study will investigate the frequency of GRADE assessments in dentistry SRs and the impact of GRADE assessments on the conclusions of a SR. It has important implications for both SR authors and users of this type of literature.