Gap finder
Search review questions
Each row is one question a systematic review asked: who, what, compared with what, and which outcome, with the effect it found and how certain that is. Words match anywhere in the field.
1,325 questions in 34 reviews · Oral medicine and oral cancer
current versionsNo studies 164 · 12.4%Ungraded 841 · 63.5%Very low 209 · 15.8%Low 72 · 5.4%Moderate 38 · 2.9%High 1 · 0.1%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
| Question | Effect | Evidence | Status / GRADE |
|---|---|---|---|
EGFR monoclonal antibody (cetuximab or nimotuzumab) plus standard therapy (radiotherapy or chemoradiotherapy) vs Standard therapy alone (radiotherapy or chemoradiotherapy) Adverse effects · People with squamous cell carcinoma of the oral cavity or oropharynx · 24 to 70 months, Skin toxicity/acneiform rash (cetuximab, grades >=3) Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy (2015) · Cochrane | RR 17.72 [8.33, 37.73] | 3 studies · 1403 participants | Ungraded |
EGFR monoclonal antibody (cetuximab or nimotuzumab) plus standard therapy (radiotherapy or chemoradiotherapy) vs Standard therapy alone (radiotherapy or chemoradiotherapy) Adverse effects · People with squamous cell carcinoma of the oral cavity or oropharynx · 24 to 70 months, Dysphagia (grades >=3) Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy (2015) · Cochrane | RR 0.93 [0.83, 1.04] | 3 studies · 1403 participants | Ungraded |
Oral cryotherapy (ice chips, ice-cold water, ice cubes or crushed ice held in the mouth during cancer treatment) vs Control (no treatment or standard/usual oral care, e.g. saline rinse) Oral pain · All patients with cancer who are receiving treatment · High-dose melphalan-based treatment prior to HSCT (haematological cancers) Interventions for preventing oral mucositis in patients with cancer receiving treatment: oral cryotherapy (2015) · Cochrane | MD -1.5 [-2.11, -0.89] | 2 studies · 85 participants | Low |
EGFR monoclonal antibody (cetuximab or nimotuzumab) plus standard therapy (radiotherapy or chemoradiotherapy) vs Standard therapy alone (radiotherapy or chemoradiotherapy) Quality of life · People with squamous cell carcinoma of the oral cavity or oropharynx · 24 to 70 months Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy (2015) · Cochrane | Only one study (Bonner 2006, 424 participants) comprehensively assessed quality of life using EORTC QLQ-C30 (v3.0) and QLQ-H&N35; no statistically significant difference between groups for global health status or any… | 1 study · 424 participants | Ungraded |
Oral cryotherapy (ice chips, ice-cold water, ice cubes or crushed ice held in the mouth during cancer treatment) vs Control (no treatment or standard/usual oral care, e.g. saline rinse) Oral mucositis (moderate to severe) · All patients with cancer who are receiving treatment · Low-dose methotrexate for GVHD prophylaxis after allogeneic HSCT Interventions for preventing oral mucositis in patients with cancer receiving treatment: oral cryotherapy (2015) · Cochrane | RR 1.01 [0.85, 1.20] | 1 study · 122 participants | Very low |
Oral cryotherapy (ice chips, ice-cold water, ice cubes or crushed ice held in the mouth during cancer treatment) vs Control (no treatment or standard/usual oral care, e.g. saline rinse) Duration of interruptions to cancer treatment · All patients with cancer who are receiving treatment · Fluorouracil (5FU) treatment for solid cancers Interventions for preventing oral mucositis in patients with cancer receiving treatment: oral cryotherapy (2015) · Cochrane | MD -8 [-9.26, -6.74] | 1 study · 80 participants | Very low |
Non-specific immunotherapy (recombinant interleukin-2 or BCG cell wall preparation) plus standard therapy vs Standard therapy alone Overall survival · People with squamous cell carcinoma of the oral cavity or oropharynx · 24 to 70 months, Recombinant interleukin-2 + surgery (De Stefani 2002) Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy (2015) · Cochrane | HR 0.52 [0.31, 0.87] | 1 study · 201 participants | Very low |
Oral cryotherapy (ice chips, ice-cold water, ice cubes or crushed ice held in the mouth during cancer treatment) vs Control (no treatment or standard/usual oral care, e.g. saline rinse) Oral mucositis (moderate to severe) · All patients with cancer who are receiving treatment · Fluorouracil (5FU) treatment for solid cancers Interventions for preventing oral mucositis in patients with cancer receiving treatment: oral cryotherapy (2015) · Cochrane | RR 0.52 [0.41, 0.65] | 5 studies · 444 participants | Moderate |
Oral cryotherapy (ice chips, ice-cold water, ice cubes or crushed ice held in the mouth during cancer treatment) vs Control (no treatment or standard/usual oral care, e.g. saline rinse) Interruptions to cancer treatment (incidence) · All patients with cancer who are receiving treatment · Fluorouracil (5FU) treatment for solid cancers Interventions for preventing oral mucositis in patients with cancer receiving treatment: oral cryotherapy (2015) · Cochrane | RR 0.44 [0.20, 0.95] | 1 study · 80 participants | Very low |
Non-specific immunotherapy (recombinant interleukin-2 or BCG cell wall preparation) plus standard therapy vs Standard therapy alone Adverse effects · People with squamous cell carcinoma of the oral cavity or oropharynx · 24 to 70 months, Nausea/vomiting (rIL-2, all grades) Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy (2015) · Cochrane | RR 1.24 [0.90, 1.70] | 1 study · 30 participants | Ungraded |
Oral cryotherapy (ice chips, ice-cold water, ice cubes or crushed ice held in the mouth during cancer treatment) vs Control (no treatment or standard/usual oral care, e.g. saline rinse) Adverse events · All patients with cancer who are receiving treatment · Fluorouracil (5FU) treatment for solid cancers Interventions for preventing oral mucositis in patients with cancer receiving treatment: oral cryotherapy (2015) · Cochrane | Adverse events reported narratively (not meta-analysed): one study reported no adverse effects (Katranci 2012); the other four 5FU studies reported low rates of very minor adverse events (headache, chills,… | 5 studies · 444 participants | Ungraded |
Non-specific immunotherapy (recombinant interleukin-2 or BCG cell wall preparation) plus standard therapy vs Standard therapy alone Adverse effects · People with squamous cell carcinoma of the oral cavity or oropharynx · 24 to 70 months, Stomatitis (rIL-2, grades >=3) Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy (2015) · Cochrane | RR 1.71 [0.33, 8.83] | 1 study · 30 participants | Ungraded |
Non-specific immunotherapy (recombinant interleukin-2 or BCG cell wall preparation) plus standard therapy vs Standard therapy alone Adverse effects · People with squamous cell carcinoma of the oral cavity or oropharynx · 24 to 70 months, Gastrointestinal complaints (BCG-CWP, all grades) Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy (2015) · Cochrane | RR 5.00 [0.27, 94.34] | 1 study · 24 participants | Ungraded |
Pilocarpine hydrochloride (parasympathomimetic) vs Artificial saliva (mucin-based) Adverse effects (side effects; treatment withdrawals) · Patients with radiation-induced salivary gland dysfunction Parasympathomimetic drugs for the treatment of salivary gland dysfunction due to radiotherapy (2015) · Cochrane | Davies 1994: main side effects with pilocarpine were nausea 20%, sweating 15%, lacrimation 10%. One participant definitely withdrew because of side effects; another may have. | 1 study · 20 participants | Ungraded |
EGFR monoclonal antibody (cetuximab or nimotuzumab) plus standard therapy (radiotherapy or chemoradiotherapy) vs Standard therapy alone (radiotherapy or chemoradiotherapy) Adverse effects · People with squamous cell carcinoma of the oral cavity or oropharynx · 24 to 70 months, Mucositis (grades >=3) Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy (2015) · Cochrane | RR 1.20 [0.96, 1.51] | 4 studies · 1495 participants | Ungraded |
EGFR monoclonal antibody (cetuximab or nimotuzumab) plus standard therapy (radiotherapy or chemoradiotherapy) vs Standard therapy alone (radiotherapy or chemoradiotherapy) Adverse effects · People with squamous cell carcinoma of the oral cavity or oropharynx · 24 to 70 months, Xerostomia (all grades) Interventions for the treatment of oral and oropharyngeal cancers: targeted therapy and immunotherapy (2015) · Cochrane | RR 0.97 [0.91, 1.04] | 3 studies · 1417 participants | Ungraded |
Oral cryotherapy for 30 minutes vs Oral cryotherapy for 60 minutes Oral mucositis (any severity) · Adults with solid cancers receiving fluorouracil (5FU) and leucovorin Interventions for preventing oral mucositis in patients with cancer receiving treatment: oral cryotherapy (2015) · Cochrane | RR 0.89 [0.62, 1.29] | 1 study · 178 participants | Very low |
Electrostimulation (device) vs Placebo (sham/placebo device) Dry mouth (xerostomia) · Adults with dry mouth due to Sjogren's Syndrome Interventions for the management of dry mouth: non‐pharmacological interventions (2013) · Cochrane | Neither trial reported usable dry mouth data; Talal 1992: 'patients using the active device experienced relief from six of the most common symptoms of xerostomia secondary to Sjogren's Syndrome, with two of these… | NR | Ungraded |
Visual screening (oral visual inspection) by trained health workers vs No screening Oral cancer mortality (disease-specific) · Apparently healthy adults aged 35 years or older (general population), living in 13 clusters in rural areas of… · 15-year follow-up Screening programmes for the early detection and prevention of oral cancer (2013) · Cochrane | RR 0.88 [0.69, 1.12] | 1 study · 191873 participants | Low |
Acupuncture vs Placebo (sham acupuncture) Oral health assessment · Adults with dry mouth due to radiotherapy (head and neck cancer) or Sjogren's Syndrome Interventions for the management of dry mouth: non‐pharmacological interventions (2013) · Cochrane | no estimate extracted | 0 studies | No studies |
Acupuncture vs Placebo (sham acupuncture) Duration of effectiveness · Adults with dry mouth due to radiotherapy (head and neck cancer) or Sjogren's Syndrome Interventions for the management of dry mouth: non‐pharmacological interventions (2013) · Cochrane | no estimate extracted | 0 studies | No studies |
Electrostimulation (device) vs Placebo (sham/placebo device) Oral health assessment · Adults with dry mouth due to Sjogren's Syndrome Interventions for the management of dry mouth: non‐pharmacological interventions (2013) · Cochrane | no estimate extracted | 0 studies | No studies |
Visual screening (oral visual inspection) by trained health workers vs No screening Costs · Apparently healthy adults aged 35 years or older (general population), living in 13 clusters in rural areas of… · 9 years (three cycles) Screening programmes for the early detection and prevention of oral cancer (2013) · Cochrane | The costs associated with the screening programme were reported after three cycles (nine years) (Subramanian 2009) (Additional Table 8). The benefit produced by a screen was 269.31 life-years saved per 100,000 for all… | 1 study | Ungraded |
Visual screening (oral visual inspection) by trained health workers vs No screening Harms of screening (false-positive/false-negative outcomes) · Apparently healthy adults aged 35 years or older (general population), living in 13 clusters in rural areas of… · 15-year follow-up Screening programmes for the early detection and prevention of oral cancer (2013) · Cochrane | No harms were reported. | 0 studies | No studies |
Electrostimulation (device) vs Placebo (sham/placebo device) Quality of life · Adults with dry mouth due to Sjogren's Syndrome Interventions for the management of dry mouth: non‐pharmacological interventions (2013) · Cochrane | no estimate extracted | 0 studies | No studies |
Acupuncture vs Placebo (sham acupuncture) Unstimulated whole saliva (UWS) · Adults with dry mouth due to radiotherapy (head and neck cancer) or Sjogren's Syndrome · 12 months (1 year follow-up) Interventions for the management of dry mouth: non‐pharmacological interventions (2013) · Cochrane | MD 0.06 [0.01, 0.11] | 2 studies · 54 participants | Low |
Visual screening (oral visual inspection) by trained health workers vs No screening Oral cancer incidence · Apparently healthy adults aged 35 years or older (general population), living in 13 clusters in rural areas of… · 15-year follow-up Screening programmes for the early detection and prevention of oral cancer (2013) · Cochrane | RR 1.14 [0.91, 1.44] | 1 study · 191873 participants | Ungraded |
Electrostimulation (device) vs Placebo (sham/placebo device) Stimulated whole saliva (SWS) · Adults with dry mouth due to Sjogren's Syndrome · End of treatment (4 weeks) Interventions for the management of dry mouth: non‐pharmacological interventions (2013) · Cochrane | MD 0.16 [-0.05, 0.37] | 1 study · 24 participants | Very low |
Acupuncture vs Placebo (sham acupuncture) Stimulated whole saliva (SWS) · Adults with dry mouth due to radiotherapy (head and neck cancer) or Sjogren's Syndrome · 12 months (1 year follow-up) Interventions for the management of dry mouth: non‐pharmacological interventions (2013) · Cochrane | MD 0.28 [0.09, 0.47] | 2 studies · 54 participants | Low |
Visual screening (oral visual inspection) by trained health workers vs No screening Stage at diagnosis (early-stage detection) · Apparently healthy adults aged 35 years or older (general population), living in 13 clusters in rural areas of… · 15-year follow-up Screening programmes for the early detection and prevention of oral cancer (2013) · Cochrane | RR 0.81 [0.70, 0.93] | 1 study · 523 participants | Ungraded |
Visual screening (oral visual inspection) by trained health workers vs No screening Quality of life · Apparently healthy adults aged 35 years or older (general population), living in 13 clusters in rural areas of… · 15-year follow-up Screening programmes for the early detection and prevention of oral cancer (2013) · Cochrane | Data on quality of life were not reported. | 0 studies | No studies |
Acupuncture vs Placebo (sham acupuncture) Quality of life · Adults with dry mouth due to radiotherapy (head and neck cancer) or Sjogren's Syndrome Interventions for the management of dry mouth: non‐pharmacological interventions (2013) · Cochrane | no estimate extracted | 0 studies | No studies |
Electrostimulation (device) vs Placebo (sham/placebo device) Patient satisfaction with treatment · Adults with dry mouth due to Sjogren's Syndrome Interventions for the management of dry mouth: non‐pharmacological interventions (2013) · Cochrane | no estimate extracted | 0 studies | No studies |
Visual screening (oral visual inspection) by trained health workers vs No screening Test performance (sensitivity and specificity) · Apparently healthy adults aged 35 years or older (general population), living in 13 clusters in rural areas of… · 15-year follow-up Screening programmes for the early detection and prevention of oral cancer (2013) · Cochrane | Across the four cycles (15 years), the reported sensitivity of the visual examination in detecting oral cancer was 67.4% (188/279). No information on the specificity or the positive predictive value of the programme… | 1 study | Ungraded |
Electrostimulation (device) vs Placebo (sham/placebo device) Adverse events · Adults with dry mouth due to Sjogren's Syndrome Interventions for the management of dry mouth: non‐pharmacological interventions (2013) · Cochrane | Wong 2003 stated 'no adverse effects were caused by Codetron'; Steller 1988 and Talal 1992 did not mention whether adverse effects occurred | NR | Ungraded |
Acupuncture vs Placebo (sham acupuncture) Dry mouth (mouth dryness, different scales) · Adults with dry mouth due to radiotherapy (head and neck cancer) or Sjogren's Syndrome · End of treatment (4-6 weeks) Interventions for the management of dry mouth: non‐pharmacological interventions (2013) · Cochrane | SMD -0.34 [-0.81, 0.14] | 2 studies · 70 participants | Low |
Toluidine blue (visual staining) vs No screening Outcome NR · Planned population: general population or high-risk / opportunistic screening groups (no eligible study) Screening programmes for the early detection and prevention of oral cancer (2013) · Cochrane | There was no evidence to support the use of adjunctive technologies like toluidine blue, brush biopsy or fluorescence imaging as a screening tool to reduce oral cancer mortality; no eligible randomised controlled trial… | 0 studies | No studies |
Powered toothbrush vs Manual toothbrush Unstimulated whole saliva (UWS) · Adults with medication-related dry mouth · 45 minutes after brushing Interventions for the management of dry mouth: non‐pharmacological interventions (2013) · Cochrane | MD -0.07 [-0.74, 0.60] | 1 study | Ungraded |
Brush biopsy (oral cytology) vs No screening Outcome NR · Planned population: general population or high-risk / opportunistic screening groups (no eligible study) Screening programmes for the early detection and prevention of oral cancer (2013) · Cochrane | There was no evidence to support the use of adjunctive technologies like toluidine blue, brush biopsy or fluorescence imaging as a screening tool to reduce oral cancer mortality; no eligible randomised controlled trial… | 0 studies | No studies |
Acupuncture vs Placebo (sham acupuncture) Patient satisfaction with treatment · Adults with dry mouth due to radiotherapy (head and neck cancer) or Sjogren's Syndrome Interventions for the management of dry mouth: non‐pharmacological interventions (2013) · Cochrane | no estimate extracted | 0 studies | No studies |
Powered toothbrush vs Manual toothbrush Stimulated whole saliva (SWS) · Adults with medication-related dry mouth · 5 minutes after brushing Interventions for the management of dry mouth: non‐pharmacological interventions (2013) · Cochrane | MD -0.13 [-1.92, 1.66] | 1 study | Ungraded |
Electrostimulation (device) vs Placebo (sham/placebo device) Unstimulated whole saliva (UWS) · Adults with dry mouth due to Sjogren's Syndrome · End of treatment (4 weeks) Interventions for the management of dry mouth: non‐pharmacological interventions (2013) · Cochrane | MD 0.02 [-0.12, 0.16] | 1 study · 24 participants | Very low |
Acupuncture vs Placebo (sham acupuncture) Adverse events · Adults with dry mouth due to radiotherapy (head and neck cancer) or Sjogren's Syndrome Interventions for the management of dry mouth: non‐pharmacological interventions (2013) · Cochrane | Acupuncture was associated with more adverse effects (tiny bruises and tiredness, mild and temporary); List 1998 noted significant eye discomfort; Pfister 2010 reported temporary increases in pain, minor bruising or… | 4 studies | Ungraded |
Electrostimulation (device) vs Placebo (sham/placebo device) Duration of effectiveness · Adults with dry mouth due to Sjogren's Syndrome Interventions for the management of dry mouth: non‐pharmacological interventions (2013) · Cochrane | no estimate extracted | 0 studies | No studies |
Visual screening (oral visual inspection) by trained health workers vs No screening Stage at diagnosis (early-stage detection) · Apparently healthy adults aged 35 years or older (general population), living in 13 clusters in rural areas of… · 15-year follow-up, High-risk individuals (tobacco and/or alcohol users) Screening programmes for the early detection and prevention of oral cancer (2013) · Cochrane | RR 0.82 [0.71, 0.95] | 1 study · 486 participants | Ungraded |
Acupuncture vs Placebo (sham acupuncture) Unstimulated whole saliva (UWS) · Adults with dry mouth due to radiotherapy (head and neck cancer) or Sjogren's Syndrome · End of treatment (4-6 weeks) Interventions for the management of dry mouth: non‐pharmacological interventions (2013) · Cochrane | MD 0.02 [0, 0.04] | 3 studies · 71 participants | Low |
Fluorescence imaging / light-based techniques vs No screening Outcome NR · Planned population: general population or high-risk / opportunistic screening groups (no eligible study) Screening programmes for the early detection and prevention of oral cancer (2013) · Cochrane | There was no evidence to support the use of adjunctive technologies like toluidine blue, brush biopsy or fluorescence imaging as a screening tool to reduce oral cancer mortality; no eligible randomised controlled trial… | 0 studies | No studies |
Powered toothbrush vs Manual toothbrush Dry mouth (xerostomia) · Adults with medication-related dry mouth Interventions for the management of dry mouth: non‐pharmacological interventions (2013) · Cochrane | Papas 2006 used a VAS to measure mouth dryness but did not report dry mouth outcome data | 1 study | Ungraded |
Visual screening (oral visual inspection) by trained health workers vs No screening Survival (proportion alive after diagnosis) · Apparently healthy adults aged 35 years or older (general population), living in 13 clusters in rural areas of… · 5-year survival Screening programmes for the early detection and prevention of oral cancer (2013) · Cochrane | A significantly higher five-year survival rate was reported in the screened group (55.5%) compared to the control (43.4%) (P value = 0.003). | 1 study · 523 participants | Ungraded |
Visual screening (oral visual inspection) by trained health workers vs No screening Oral cancer mortality (disease-specific) · Apparently healthy adults aged 35 years or older (general population), living in 13 clusters in rural areas of… · 15-year follow-up, High-risk individuals (tobacco and/or alcohol users) Screening programmes for the early detection and prevention of oral cancer (2013) · Cochrane | RR 0.76 [0.60, 0.97] | 1 study | Ungraded |