Objective: This analysis discusses common problems with systematic reviews (SRs) and presents a novel solution, the structured critical analysis (SCA) that can be incorporated into a SR or used as an alternative literature review design.Methods: A cross-sectional survey of current SRs related to interdisciplinary restorative dentistry was obtained by evaluating 100 current SRs for their self-reported methodological quality and its effect on scientific validity.Results: The preferred reporting items for systematic reviews and meta-analyses protocol (PRISMA) was used in 99/100 SRs, but only 8/100 reported a low risk of bias. High statistical heterogeneity precluding meta-analysis was found in 44/100 SRs. Only 94 paragraphs/100 SRs provided critical analysis.Discussion: Significant problems were found with current SRs that can compromise their reliability as the premier level of evidence for clinical science research. The reader must be aware of these deficiencies to correctly interpret the SR and cannot rely on the format alone.
Keywords: Systematic review; clinical heterogeneity; methodological quality; statistical heterogeneity; structured critical analysis.