Selection bias in Systematic Reviews of dental caries management in children and adolescents: a meta-research study

This study aims to analyze the prevalence of selection bias in systematic reviews focused on the management of dental caries in children and adolescents. Additionally, it seeks to investigate the association between this bias and factors such as journal impact factor, adherence to the PRISMA guidelines, risk of bias assessment (ROBIS), and methodological quality (AMSTAR). Given the critical role of systematic reviews in synthesizing evidence, informing clinical decision-making, and supporting the development of trustworthy clinical practice guidelines, identifying and quantifying selection bias is essential to ensure the reliability of conclusions drawn from these studies. This meta-research study will use a pre-existing sample of systematic reviews, previously registered on the Open Science Framework (OSF) under the project “SPIN in systematic reviews on the management of caries lesions in children and adolescents” (https://doi.org/10.17605/OSF.IO/SQ423). Data extraction will be performed independently by two reviewers and will include key study characteristics such as publication year, country of the corresponding author, journal impact factor, citation count, adherence to PRISMA guidelines, risk of bias assessment, and methodological quality. Selection bias will be assessed based on criteria such as clarity and justification of inclusion/exclusion criteria, comprehensiveness of search strategies, inclusion of studies with potential conflicts of interest, and whether the last literature search was conducted close to the publication date. The ROBIS tool will be used to evaluate risk of bias, while AMSTAR will assess methodological quality. Statistical analyses will be conducted using Jamovi software, employing chi-square tests to determine associations between selection bias and journal impact factor, risk of bias, and methodological quality. It is hypothesized that selection bias is highly prevalent in systematic reviews on dental caries management in children and adolescents. Furthermore, this bias is expected to be associated with lower impact factors journals, lower adherence to PRISMA guidelines, and poorer methodological quality. By identifying these patterns, the study aims to highlight the need for more rigorous methodologies in systematic reviews, contributing to improved evidence reliability and the production of higher-quality recommendations in clinical practice guidelines. This research will provide critical insights into the integrity of systematic reviews in pediatric dentistry, reinforcing the importance of high methodological standards to enhance the quality, applicability, and trustworthiness of evidence-based recommendations, particularly those informing clinical practice guidelines.