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\subsection{\textbf{Keywords:}}  bias;meta-analysis;oncology;quality;systematic review  \section{Introduction}  The use of systematic reviews and meta-analyses has become of increasing importance in evidence based medicine for clinicians to seek out consistent and reliable information on treatments and care guidelines in medicine \cite{14764293}. In part, the reasoning for reliance on systematic reviews and meta-analyses is that both are considered to be helpful due to pooling of results of multiple studies to provide a broader view of information of interest, and by broadening the pool of data, the idea is that bias would become less of an issue in studies \cite{7500513}. Quality assessment is a crucial component of any study and consequences of inadequate quality reporting or evaluation within research studies, can lead to exaggerated treatment effects when bias of participants is not taken into account in study design \cite{gurusamy2009assessment}. Assessing benefits and harms of interventional procedures is crucial in clinical application of trials and it is of great value to determine whether studies are conducted after assessing bias or low quality of studies.   Many scales have been designed to address concerns about high risk of bias or low quality in earlier studies, however, recent evidence indicates scales may not be the best means of assessing quality measures, and rather certain design features should be viewed to give a clearer picture of bias in trials \cite{lohr1999assessing}. The \textit{Cochrane Handbook for Systematic Review of Interventions} have been update continually to address changes in assessment of quality \cite{Higgins_2011}.  \section{Methods}  \subsection{Search Criteria and Eligibility}  
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