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\section{Discussion/Conclusion}
This study provides a comprehensive and recent assessment of methodological quality and risk of bias assessment in
journals associated with oncology. oncology journals. Our main findings were that
comprehensive reporting creporting of quality measures in systematic reviews and meta-analyses in major oncology journals was moderate to low, with actual assessment of methodological being present in
87 48\% of
the 182 articles (48\%), studies and inclusion of studies with high risk of bias or low quality present in
35 of the 45 or 76\% of studies. This is
surprisingly high in comparison to similar studies assessing risk of bias evaluations such as in Hopewell et al., where 20\% of non-Cochrane reviews neglected to report methods used. In addition the inclusion of studies with high risk of bias or low quality was also an issue, with 76\% of studies with high risk of bias or low quality studies being included. This is comparable to the proportion of trials with high risk of bias included in previous studies where 75\% of trials contained one or more trials with high risk of bias \cite{hopewell2013incorporation}. Of course Hopewell et al. used the Cochrane Database of Systematic Reviews, which is known for its stringent criteria for methodological quality. Our study also focused only on oncology journals while the Hopewell et al. study focused on Cochrane and non-cochrane reviews across many fields.
However another problem still persists and that is the inclusion of high risk of bias or low quality studies was not the only problem in these studies, but rather the problem was that out of the included articles further analysis was not conducted to address additional bias or low quality. The completeness of quality measure reporting in oncology journals appears to be lower compared to reports in related fields such as orthodontics in which PRISMA results were 64\% compared to the quality assessment found in oncology journals of 50\% \cite{tunis2013association}. The use of high risk of bias or low quality appears to not be the focus in the assessment of quality in oncology journals. The variety of quality assessment scales also indicates a problem in reporting consistently and makes comparison amongst similar studies problematic \cite{Balk_2002}.
Another point of interest was that despite presence of high quality bias or low quality studies being included in the data set, most oncology journals did not conduct further analysis to address increased bias, and it is possible that due to varied criteria of assessing quality, most studies lack a clear awareness of which types of tools to use \cite{chalmers1983bias}. Grading of scales proves to be a problem due to lack of consistent types of scales within papers \cite{J_ni_1999}.
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