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\subsection{\textbf{Keywords:}}  meta-analysis;oncology;quality; risk of bias;systematic review  \section{Introduction}  The use of systematic reviews and meta-analyses has become increasingly important in evidence-based medicine as clinicians seek out consistent and reliable information on treatments and care guidelines in medicine \cite{14764293}. Since systematic reviews synthesize evidence from multiple studies, clinicians are able to better understand the individual trials comprising the review as well as the efficacy of the therapy summarized across all available, relevant evidence. One essential feature that lends confidence to the findings of a review is an appraisal of the methodology among studies in a systematic review. In cases where systematic reviewers have concluded that primary studies are of high methodological quality or have low potential for biased outcomes, clinicians can have more confidence in the study findings. For example, Yang et al evaluated the toxicity and efficacy of chemotherapy plus cetuximab in relation to chemotherapy alone in patients with advanced non-small cell lung cancer. The systematic review was comprised of 4 trials. A risk of bias assessment of these trials was conducted, and the authors concluded that risk of bias was low for overall survival and one-year survival rates but high for all other outcomes due to a lack of blinding. In part, Hence,  the reasoning for reliance on systematic reviews and meta-analyses is reviewers concluded  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 chemotherapy plus cetuximab is better than chemotherapy alone for improving overall survival;  the pool risk  ofdata, the idea is that  biaswould 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 played an important role  in clinical application of trials and it is of great value to determine whether studies are conducted after assessing bias or low quality the interpretation  of studies. the summary effect.    Many scales have been designed in response  toaddress  concerns about high risk of bias or low the methodological  quality in earlier studies, or potential for bias among primary studies;  however, recent evidence indicates scales may not be the best means of assessing quality measures, and rather way to appraise studies. Rather,  certain design features should be viewed reviewed  to give provide  a clearer picture of bias in trials \cite{lohr1999assessing}.The Cochrane Handbook for Systematic Review of Interventions has been updated continually to address changes in assessment of quality \cite{higgins2011cochrane}. Similarly the Jadad grading scale has also been designed as a means of unifying quality measures amongst clinical trials \cite{jadad1996assessing}. The first major guideline for reporting in systematic reviews and meta-analyses came out in 1996 and was referred to as the Quality of Reporting of Meta-Analyses (QUORUM), and has been followed thereafter by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement \cite{shamseer2015preferred}. The \textit{Cochrane Handbook for Systematic Review of Interventions} have been update continually to address changes in assessment of quality \cite{Higgins_2011}. Similarly the \textit{Jadad} grading scale has also been designed as a means of unifying quality measures amongst clinical trials \cite{jadad1996assessing}.   The first major guideline for reporting in systematic reviews and meta-analyses came out in 1996 and was referred to as the Quality of Reporting of Meta-Analyses (QUORUM), and has been followed thereafter by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement \cite{Moher_2011}. After publication of the QUORUM statement there was an improvement in how items from the checklist were reported and quality of reporting improved in critical care literature\cite{Delaney_2007}. Despite a clear move toward progress in reporting of quality measures, there still remains significant differences in designs and gradings between each study\cite{higgins2008cochrane}. According to The Cochrane Collaboration, criteria for evaluation of bias in studies should be domain-based and in fact that further analysis would be needed if high risk of bias or low quality studies are included \cite{higgins2008cochrane}. Reporting of quality measures and methodological quality assessment is crucial for clinicians to have the best information for patient care.    
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