Oral Epithelial Dysplasia Grading Systems: A Systematic Review & Meta-Analysis

Area of Science:

• Oral pathology
• Histopathology
• Systematic reviews

Background:

• Oral epithelial dysplasia (OED) grading systems are crucial for diagnosing oral potentially malignant disorders.
• Current systems exhibit variability, necessitating a review of their efficacy and reproducibility.

Purpose of the Study:

• To conduct a systematic review and meta-analysis of OED grading systems.
• To qualitatively and quantitatively analyze the performance of different OED assessment systems.

Main Methods:

• Systematic literature search across six databases following PRISMA guidelines.
• Quality appraisal using the Johns Hopkins Research Evidence Appraisal Tool.
• Meta-analysis of four studies comparing OED grading systems, including WHO and binary systems.

Main Results:

• The binary system demonstrated superior inter-observer agreement compared to the WHO system for OED grading.
• However, substantial error in inter-observer agreement limits the clinical impact of this finding.
• Significant heterogeneity and lack of reliable reproducibility were observed across grading systems.

Conclusions:

• Existing OED grading systems, including the binary and WHO systems, suffer from poor reproducibility.
• Further research is needed to develop and validate more reliable and reproducible OED grading methodologies.