Spin and reporting in systematic reviews with meta-analysis of randomized clinical trials in restorative dentistry.

OBJECTIVE: To estimate the prevalence of spin and completeness of reporting of systematic reviews with metanalysis (SRMAs) in restorative dentistry. METHODS: Inclusion criteria were SRMAs of randomized clinical trials of restorative dentistry on survival, success, or failure rates of treatment in humans, with no language or year restriction. SRMAs performed with non-RCTs were excluded. PubMed/MEDLINE, Web of Science, Scopus, Embase, and Cochrane Collaboration Library were searched from inception to April 2022. Outcomes were the prevalence of spin (primary outcome) and completeness of reporting (secondary outcome) in the abstract and full text. Data were reported through means and standard deviations or absolute and relative frequencies. Spin in each item was considered low when occurring in less than 25% of the papers, moderate (25 to 75%), or high (more than 75%). RESULTS: We identified 7029 studies and 49 unique manuscripts were included. There was a moderate presence of spin in the abstracts and low in full texts. In the abstracts, 65.9% did not report adverse events; while in the abstract and full text, more than 16% reported a conclusion containing recommendations for clinical practice not supported by the findings. Regarding completeness of reporting, there was poor reporting for most items in the abstract while there was an adequate report in full texts, except for register name and registration number (not reported in 32.7%). CONCLUSIONS: Abstract of SRMAs in restorative dentistry should be better reported. Spin and poor reporting were more frequent in the abstracts, which misleads readers and could lead to inadequate clinical recommendations. CLINICAL SIGNIFICANCE: Spin and incomplete reporting are a threat to evidence-based practice, especially in systematic reviews. Therefore, care providers, researchers, and other stakeholders should be aware of the possibility of spin in systematic reviews and other sources to prevent misinterpretation, which could lead to inadequate decisions and treatments.

Female and Worst Academic Performance are Associated with Anxiety and Stress among Dental Students / Mulheres e Pior Desempenho Acadêmico Estão Associados com Ansiedade e Estresse em Estudantes de Odontologia

This study aimed to assess the levels and associated factors of stress and anxiety in dental students during the Covid-19 pandemic. This cross-sectional study involved both undergraduate and graduate dental students regularly enrolled in the first semester of 2020 of one University. An online structured questionnaire was applied, and demographical, behavioral, academic performance, fear and anxiety related to the Covid-19 pandemic were collected. The 21-item Depression Anxiety Stress Scale (DASS-21) was applied, but only the subscales of anxiety and stress were considered. Adjusted analyses were performed using Poisson regression with robust variance. To both anxiety and stress, independent analyses were performed considering the different levels of study (undergraduate and graduate dental students). At least moderate anxiety was detected in 42.9% and 24.7% of undergraduate and graduate students, respectively. Meanwhile, at least moderate stress was observed in 41.7% and 29.9% of undergraduate and graduate students, respectively. In the multivariate analyses, female undergraduate dental students presented significantly more anxiety (prevalence ratio [PR]: 1.57; 95% confidence interval [95%CI]: 1.11 ­ 2.22) and stress (PR: 1.54; 95%CI: 1.06 ­ 2.24) when compared to males. Conversely, undergraduate dental students with better academic performance demonstrated lower rates of anxiety (PR: 0.86; 95%CI: 0.75 ­ 0.98). Females undergraduate dental students demonstrate higher rates of anxiety and stress, and the academic performance may influence the levels of anxiety in these individuals. (AU)

O estudo objetivou avaliar os níveis e fatores associados de estresse e ansiedade em estudantes de Odontologia durante a pandemia de Covid-19. Esse estudo transversal envolveu alunos de graduação e pós-graduação em Odontologia regularmente matriculados no primeiro semestre de 2020 de uma Universidade. Um questionário estruturado online foi aplicado, e variáveis demográficas, comportamentais, performance acadêmica, medo e ansiedade relacionados à pandemia de Covid-19 foram coletadas. A "Depression Anxiety Stress Scale" (DASS-21) de 21 itens foi aplicada, mas somente os domínios de ansiedade estresse foram considerados. Análises ajustadas foram realizadas utilizando regressão de Poisson com variância robusta. Para ambos ansiedade e estresse, análises independentes foram realizadas considerando os diferentes níveis de estudo (estudantes de odontologia de graduação e pós-graduação). Pelo menos ansiedade moderada foi detectada em 42,9% e 24,7% dos alunos de graduação e pós-graduação, respectivamente. Já o estresse pelo menos moderado foi observado em 41,7% e 29,9% dos alunos de graduação e pós-graduação, respectivamente. Nas análises multivariadas, mulheres estudantes de graduação apresentaram significativamente mais ansiedade (razão de prevalência [RP]: 1,57; intervalo de confiança de 95% [IC95%]: 1,11 ­ 2,22) e maior estresse (RP: 1,54; IC95%: 1,06 ­ 2,24) quando comparados com homens. Contudo, estudantes de graduação com melhor performance acadêmica demonstraram menores taxas de ansiedade (RP: 0,86; IC95%: 0,75 ­ 0,98). Estudantes de graduação do sexo feminino demonstraram maiores taxas de ansiedade e estresse, e a performance acadêmica pode influenciar os níveis de ansiedade desses indivíduos. (AU)