Outcomes reporting in systematic reviews on vital pulp treatment: A scoping review for the development of a core outcome set

Abstract

Background: A large number of research reports on vital pulp treatment (VPT) has been published over the last two decades. However, heterogeneity in reporting outcomes of VPT is a significant challenge for evidence synthesis and clinical decision-making. Objectives:To identify outcomes assessed in VPT studies and to evaluate how and when outcomes are measured. A subsidiary aim was to assess evidence for selective reporting bias in the included studies. The results of this review will be used to inform the development of a core outcome set (COS) for endodontic treatments. Methods: Multiple healthcare bibliographic databases, including PubMed/ MEDLINE, Ovid EMBASE, Scopus, Cochrane Database of Systematic Reviews and Web of Science were searched for systematic reviews published between 1990 and 2020, reporting on VPT. Screening, data extraction and risk of bias assessment were completed independently by two reviewers. Outcomes' information was extracted and aligned with a healthcare taxonomy into five core areas: survival, clinical/physiological changes, life impact, resource use and adverse events.Results: Thirty-six systematic reviews were included, 10 reporting on indirect pulp capping or selective caries removal, nine on direct pulp capping, eight on pulpotomy and nine on combined VPTs. There was considerable variation in the outcomes reported in these reviews and their included studies. Clinician-reported outcomes were used considerably more often than patient-reported outcomes. A range of instruments and time points were used for measuring outcomes. Several of the reviews were assessed as having low risk of selective reporting bias, but many did not specifically report this domain, whilst others did not provide risk of bias assessment at all. Discussion: Considerable variation in selection of outcomes and how and when they are measured and reported was evident, and this heterogeneity has implications for evidence synthesis and clinical decision-making. Conclusions:Whilst there is a lack of consistency, several potentially important outcomes for VPT, including pulp survival, incidence of post-operative pain and Year Country Journal name VPT modality reported Outcomes reported in review

The importance of establishing a core outcome set for endodontic clinical trials and outcomes studies

“…How to cite this article: El-Karim, I., Duncan, H.F., Nagendrababu, V. & Clarke, M. (2022) The importance of establishing a core outcome set for endodontic clinical trials and outcomes studies. International Endodontic Journal, 00, 1-7.…”

“…In endodontics, CROs are interpretation of data obtained from detailed history taking together with clinical and/or radiographic examination. CROs such as a history of pain and heightened, painful response to percussion/ palpation are crucial outcomes that have been used in recent endodontic treatment outcomes studies (Cushley et al, 2022;Shah et al, 2022). However, the measures used for CROs are often not standardized or validated.…”

Assessment of Pulpal Status in Primary Teeth Following Direct Pulp Capping in an Experimental Canine Model

“…The primary goal of pulp therapy is to maintain the integrity and health of the teeth and their supporting tissues while maintaining the vitality of the pulp [ 1 ]. The prognosis of teeth that underwent vital pulp therapy (VPT) procedures is evaluated on the basis of clinical symptoms, percussion, radiographic examination, and pulp testing [ 2 ]. Diagnostic pulp tests are, therefore, an essential aid in determining the outcome of various pulp-capping procedures.…”

Outcomes reporting in systematic reviews on revitalization: A scoping review for the development of a core outcome set

“…The aim of the systematic review process is to identify outcomes reported in all clinical studies in humans in order to generate list of outcomes that are to be categorized according to health intervention taxonomy (Dodd et al, 2018) for validation via a subsequent Delphi process and consensus meeting. The process has been completed for VPT (Cushley et al, 2022), surgical endodontics (Shah et al, 2022) and non-surgical root Conclusions: Several important outcomes including survival, root development, tooth discolouration and periapical healing have been identified in this review which could inform the development of a COS in this area.…”