UPDATE: a version of this has been accepted for publication as a letter to the editor in the medical journal Laryngoscope.
Systematic reviews and meta-analyses are supposed to be high-quality reviews of the medical literature that represent the highest level of scientific evaluation and evidence. Unfortunately, all that glitters in not gold. I have written previously about the fact that:
- Systematic reviews published in the top otolaryngology-head and neck surgery journals almost universally have important, key flaws in their analyses. We have published a rigorous scientific evaluation, showing that these flaws make it such that over 99% of these published reviews provide critically low confidence in their results;
- The same is true across all medical fields, including sleep medicine;
- Oral and myofunctional therapy is not a proven treatment for adults with obstructive sleep apnea. With several co-authors who are recognized internationally across many disciplines as true experts in sleep medicine, we wrote a paper discussing how oral myofunctional therapy for adults obstructive sleep apnea has no real scientific evidence to support it.
Nevertheless, we continue to see publications of systematic reviews and meta-analyses that give the impression that oral myofunctional therapy is a valid approach. It is not proven, as there is virtually no scientific evidence. What authors have done is combine results of single studies of very-different exercise-based programs that do NOT represent oral myofunctional therapy. This is not correct scientifically and not appropriate for patients suffering from obstructive sleep apnea, a potentially-serious medical disorder that also can affect daytime functioning and quality of life.
As I have said before, we can and must do better than publishing sloppy science – and allowing patients and providers to come away with false impressions.