Citation metrics and quality of the top cited systematic reviews in dentistry: a meta-research

Abstract Objective: This study evaluated the methodological quality and risk of bias of the most cited systematic reviews in dentistry. Methods: An electronic search was performed in Scopus database to select the 50 most cited systematic reviews, including any type of study design as primary studies, with outcomes in dental sciences. Two reviewers independently selected the studies and extracted the data items. Reporting of general components was assessed according to the PRISMA Statement. The methodological quality was assessed using the AMSTAR-2 tool checklist. The risk of bias was assessed using the ROBIS tool. The correlation between the citation and the AMSTAR-2 and ROBIS scores was also investigated. Results: The 50 most cited systematic reviews in dentistry varied from 252 to 980 citations and were published between 2002 and 2015. The adherence to PRISMA items varied, presenting low adherence rates for some items. Most reviews presented critically low (n=43; 86%) methodological quality, while 3 studies showed low quality (6%), 3 presented moderate quality (6%), and only 1 study was of high quality (2%). Risk of bias assessment showed a high risk of bias mainly for domains 1 (n=32, 64%), 2 (n=24 studies, 48%), and 4 (n= 25, 50%). Coefficients between the number of citations with AMSTAR-2 and ROBIS scores showed weak correlation (rho < 0.28). Conclusions: The most cited systematic reviews in dentistry present critically low methodological quality and a high risk of bias for several domains. Reporting guidelines adherence is also questionable regarding the analysis of the available data. Clinical Significance: A poor-quality systematic review can provide misleading conclusions that might affect decisions. The readers of systematic reviews should be aware about those possible falls.