In the judgement of internal validity of RCTs, SYSTEM's focus lies on the risk assessment of selection- performance/detection- and attrition bias. In regard to assessing selection- performance/detection bias, SYSTEM has also departed from the common practice and adopted stricter criteria. These criteria do include the common focus on
Adequacy of reported attempts for bias control but also includes focus on Adequacy of reported results of attempts for bias control.
In regard to assessment of attrition bias, the SYSTEM approach follows the quantitative method of sensitivity analysis by computation of assumed worst-case scenarios / clinical outcomes for study subject that have been lost to follow-up in the reviewed trials. This method was developed in collaboration with the help of Prof Paul Fatti from the School of Statistics & Actuarial Science, University of the Witwatersrand.
The above stated methods are novel to common systematic review methodology and have been applied successfully in SYSTEM's systematic review articles that were accepted in international peer-reviewed dental journals. Besides the adoption of these novelties, SYSTEM's methodology is based on common consensus for systematic reviews, i.e. as represented by the Cochrane collaboration and its reporting follows recommendations of the PRISMA statement