einstein (São Paulo). 01/Jul/2015;13(3):480.

Letter to the editor on: Oral care and nosocomial pneumonia: a systematic review. einstein (São Paulo). 2015;13(2):290-6.

DOI: 10.1590/S1679-45082015CE3478

To the Editor:

I read with interest the systematic review “Oral care and nosocomial pneumonia: a systematic review” published in einstein (São Paulo), which describes evidences of an association between oral care and reduction in the incidence of nosocomial pneumonia. I would like to express some concerns about the study. First, the search strategy used was not reported, therefore the search strategy did not allow replication. In addition, articles included and excluded in the study were not identified in the table. I conducted a search in PubMed/MEDLINE and LILACS using the uniterms mentioned by the authors of the review ((((((nosocomial pneumonia) AND oral care))OR ((nosocomial pneumonia) AND oral hygiene)) OR ((nosocomial pneumonia)AND oral microflora))) OR (((((pneumonia associated with mechanical ventilator) ANDoral care))OR ((pneumonia associated with mechanical ventilator) AND oral hygiene)) OR((pneumonia associated with mechanical ventilator) AND oral microflora)). The search retrieved 235 reports in PubMed/MEDLINE and 20 reports in LILACS. Because the authors did not describe the number of articles retrieved in each database, I could not compare the results found. The authors identified 297 reports in 3 databases, and 52 had full-text available; of these, only 14 were included in the study. In my search I identified more full-text articles. I inquire about this difference presented in the flowchart. In addition, what criteria do authors used to include or exclude an article, when reviewers’ opinion was different? Was there a third independently and blinded author in charge to decide whether to exclude or include an article? Did an agreement exist between the two first reviewers? Perhaps, the answer to these questions can explain the inclusion of less articles in the sample.

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