Abstract
Aim: this overview aims to assess the evidence for best practice concerning methods of early detection / screening for oral cavity cancer (OCC) in primary care dental settings.
Methods: Multiple databases were searched for clinical guidelines and systematic reviews, with no language restrictions. A novel search strategy was developed to include professional organisation/associations websites. The methodological quality of the included records was assessed by at least two reviewers using validated and reliable instruments: AGREE II tool for clinical guidelines; AMSTAR and ROBIS tools for systematic reviews. Reviewers’ quality appraisal ratings for the tools were compared and disagreements were resolved by discussion. Data extraction included capturing recommendations and evidence grading scores as recorded in the reviewed articles. A narrative synthesis approach was undertaken to assess the evidence of extracted data, focusing on the themes of: description of the clinical examination, frequency of the assessment, use of adjunct methods, and whether the approach should be population, opportunistic, or targeted based on risk factors; and taking account of the quality appraisal and recency of publication.
Results:12 systematic reviews and 24 clinical guidelines were identified for inclusion. AGREE II scoring was consistent between the overall quality score and the rigor of the guideline development domain of the tool. Quality scores ranged from 2 to 6 overall, with corresponding domain scores ranging from 3% to 85%. AMSTAR and ROBIS showed good consensus in the reviewers scores, with articles having a high AMSTAR score being rated as “low /unclear” risk of bias in ROBIS. The narrative synthesis showed a lack of use of high level evidence within the clinical guidelines.
Conclusions: The recommendations in the clinical guidelines were based on limited evidence in systematic reviews, and indicated the need for more research in relation to oral cavity cancer early detection/ screening for dental healthcare professionals.
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