How to Use Evidence-Based Dental Practices to Improve Clinical Decision-Making
Published on 15. November 2019
299 pages
978-1-68447-062-4 (ISBN)
Description
This book is a one-stop resource for learning how to harness the power of the latest scientific information and optimize patient care. How to Use Evidence-Based Dental Practices to Improve Your Clinical Decision-Making is the definitive resource for dental students and practitioners who want to learn from leaders in the field of evidence-based dentistry (EBD); quickly conduct searches for the latest research; master the skill of critically appraising clinical studies; confidently apply the latest research to patient care; teach others how to inform their practice with the latest clinical evidence; and access everything they need to become an EBD all-star. The ADA Center for Evidence-Based Dentistry oversaw the development of this publication. Dental teams and educators alike will find it a useful resource for incorporating the most up-to-date scientific evidence in clinical decisions and instilling others with the curious mindset needed to provide evidence-based health care. Includes link to e-book.
More details
Other editions
Additional editions
American Dental Association | Alonso Carrasco-Labro | Romina Brignardello-Petersen
How to Use Evidence-Based Dental Practices to Improve Clinical Decision-Making
Book
11/2019
American Dental Association
€116.55
Shipment within 3-4 weeks
Persons
The ADA supports practicing dentists, dental hygienists,assistants, and practice managers, as well as students, with print and digitalprofessional resources and patient education that promote health, safety, andeducation as well as the management and maintenance of dental practices. We arestrong advocates for public health ? fighting oral cancer and combating theopioids crisis ? and we're teaming up with industry partners to help you stayhealthy from the dental chair to daily care at home. We will continue workingtoward our vision ? working side by side with member dentists ? to achieveoptimal health for all.
Content
- Intro
- Title
- Copyright
- Contents
- Preface
- How to Use This Book
- Chapter 1. Understanding and Applying the Principles of Evidence-Based Dentistry (EBD)
- Introduction
- Definition and Principles of EBD
- The Process of EBD
- Chapter 2. Searching for the Best Oral Health Evidence: Strategies, Tips, and Resources
- Introduction
- General Tips for Searching Electronic Resources
- Searching Workflow
- Resources
- Comprehensive Resources
- Epistemonikos
- Trip
- Summaries and Guidelines: Point-of-Care Resources
- UpToDate
- ClinicalKey
- Lexicomp
- ECRI Guidelines Trust
- ADA Center for Evidence-Based Dentistry
- Preappraised Resources
- Cochrane Library
- Journals
- Evidence-Based Dentistry (EBD)
- Journal of Evidence-Based Dental Practice (JEBDP)
- The Journal of the American Dental Association (JADA)
- Nonpreappraised Resources
- PubMed
- MEDLINE
- Embase
- Web of Science/Scopus
- Google and Google Scholar
- Citation Managers
- Gray Literature
- Patient Information Resources
- Conclusion
- Chapter 3. How to Appraise and Use an Article about Therapy
- Introduction
- Clinical Questions of Therapy
- What Study Design Best Addresses Questions of Therapy?
- Critically Appraising an RCT to Inform Clinical Decisions
- How Serious Is the Risk of Bias?
- Did the intervention and control groups start with the same prognosis?
- Was prognostic balance maintained as the study progressed?
- Were the groups prognostically balanced at the completion of the study?
- What Are the Results?
- How large was the treatment effect?
- How precise was the estimate of the treatment effect?
- How Can I Apply the Results to Patient Care?
- Were the study patients similar to my patients?
- Were all patient-important outcomes considered?
- Are the likely treatment benefits worth the potential harms and costs?
- Conclusion
- Chapter 4. How to Use an Article about Harm
- Introduction
- Clinical Questions of Harm
- What Study Design Best Addresses Questions of Harm?
- Critically Appraising Observational Studies to Inform Clinical Decisions
- How Serious Is the Risk of Bias?
- Are exposed and unexposed study participants sufficiently similar?
- Is information collected in the same way in exposed and unexposed study participants?
- What Are the Results?
- How strong is the association between exposure and outcome?
- How precise was the estimate of the risk?
- How Can I Apply the Results to Patient Care?
- Were the study patients similar to the patients in my practice?
- Was the follow-up sufficiently long?
- Is the exposure similar to what might occur in my patient?
- Are there any benefits that offset the risks associated with the exposure?
- Conclusion
- Chapter 5. How to Appraise and Use an Article about Diagnosis
- Introduction
- Clinical Questions of Diagnosis
- What Study Design Best Addresses Questions About Diagnosis?
- Critically Appraising a Study Assessing the Properties of a Diagnostic Test to Inform Clinical Decisions
- How Serious Is the Risk of Bias?
- Did participating patients present a diagnostic dilemma?
- Did investigators compare the test with an appropriate, independent reference standard?
- Were the investigators who interpreted the test and reference standard blinded to the other results?
- Did investigators apply the same reference standard to all patients regardless of the results of the test under investigation?
- What Are the Results?
- How Can I Apply the Results to Patient Care?
- Will the reproducibility of the test results and its interpretation be satisfactory in my clinical setting?
- Are the study results applicable to the patients in my practice?
- Will the test results change my management strategy?
- Will patients be better off as a result of the test?
- Conclusion
- Chapter 6. How to Use a Systematic Review and Meta-Analysis
- Introduction
- Knowledge Synthesis and Translation
- What Is the Difference Between Narrative and Systematic Reviews?
- Why Are Systematic Reviews Considered to Be a Study Design?
- Critically Appraising Systematic Reviews to Inform Clinical Decisions
- How Serious Is the Risk of Bias?
- Did the review present explicit and appropriate eligibility criteria?
- Was the search for relevant studies exhaustive?
- Did the primary studies have a low risk of bias?
- Were the selection and assessment of primary studies reproducible?
- What Are the Results?
- Were the results similar from study to study?
- What are the overall results of the review?
- Anatomy of a Meta-Analysis
- How precise were the results?
- What is the overall quality of the evidence (also known as confidence in the estimate of effect)?
- How Can I Apply the Results to Patient Care?
- Were all patient-important outcomes considered?
- Are the likely treatment benefits worth the potential harms and costs?
- Conclusion
- Chapter 7. How to Use Patient Management Recommendations from Clinical Practice Guidelines
- Introduction
- Evidence-Based Clinical Practice Guidelines
- Structured Process of Developing Management Recommendations
- Where to Find Clinical Practice Guidelines
- Critically Appraising Patient Management Recommendations
- Are the Recommendations Clear and Comprehensive?
- Is the recommended intervention clear and actionable?
- Is the alternative clear?
- Were all the relevant outcomes important to patients explicitly considered?
- Was the Recommendation Made on the Basis of the Best Current Evidence?
- Are Values and Preferences Associated with the Outcomes Appropriately Specified?
- Do the Authors Indicate the Strength of Their Recommendations?
- Is the Evidence Supporting the Recommendation Easily Understood?
- For strong recommendations, is the strength appropriate?
- For weak recommendations, does the information provided facilitate shared decision-making?
- Was the Influence of Conflicts of Interest Minimized?
- Conclusion
- Chapter 8. How to Appraise an Article Based on a Qualitative Study
- Introduction
- When Is Qualitative Research Relevant?
- Where to Find Qualitative Studies
- Critically Appraising Qualitative Research to Inform Clinical Decisions
- Are the Results Credible?
- Was the Choice of Participants or Observations Explicit and Comprehensive?
- Was Research Ethics Approval Obtained?
- Was Data Collection Sufficiently Comprehensive and Detailed?
- Were the Data Analyzed Appropriately, and Were the Findings Corroborated Adequately?
- What Are the Results ?
- How Can I Apply the Results to Patient Care?
- Does the Study Offer Helpful Theory?
- Does the Study Help Me Understand the Context of My Practice?
- Does the Study Help Me Understand Social Interactions in Clinical Care?
- Conclusion
- Chapter 9. How to Appraise and Use an Article about Economic Analysis
- Introduction
- Why Economic Analysis in Dentistry?
- Cost-Effectiveness Analysis
- Cost-Utility Analysis
- Cost-Benefit Analysis
- Trial-Based versus Decision Model-Based Economic Analyses
- Critically Appraising an Economic Analysis to Inform Clinical Decisions
- How Serious Is the Risk of Bias?
- Are results reported separately for relevant patient subgroups?
- Were consequences and costs measured accurately?
- Did investigators consider the timing of costs and consequences?
- What Are the Results?
- What were the incremental costs and effects of each strategy?
- Do incremental costs and effects differ between subgroups?
- How much does allowing for uncertainty change the results?
- How Can I Apply the Results to My Patient Care?
- Are the viewpoints and setting used in the study relevant to my context?
- Are the treatment benefits worth the risks and costs?
- Can I expect similar costs in my setting?
- Conclusion
- Chapter 10. How to Avoid Being Misled by Clinical Studies' Results in Dentistry
- Introduction
- Guidance on How to Avoid Being Misled by the Results of Clinical Studies
- 1. Read only the methods and results sections
- disregard the inferences
- 2. Read synoptic abstracts published in secondary publications (preappraised resources) for evidence-based dentistry
- 3. Beware of large treatment effects presented in trials with few events
- 4. Beware of statements of statistical significance that claim clinical significance
- 5. Beware of differences that are not statistically significant being interpreted as equivalence
- 6. Beware of uneven emphasis on benefits and harms
- 7. Beware of misleading subgroup analyses
- Conclusion
- Chapter 11. What Is the Difference between Clinical and Statistical Significance?
- Introduction
- Statistical Significance
- Type I Error
- Type II Error
- Study Power
- Issues Pertaining to Statistical Significance
- Clinical Significance
- Minimal Important Difference (MID)
- Patient-Reported Outcome Measures (PROMs)
- Surrogate Outcomes
- Interpreting Research Findings
- Confidence Intervals (CIs)
- CIs and MID
- Discussion
- Conclusion
- Chapter 12. A Primer to Biostatistics for Busy Clinicians
- Introduction
- Research Design and Clinical Interpretation
- Experimental Trial
- Observational Studies
- Measures of Association
- Mean Difference
- Standard Mean Difference
- Absolute Risk
- Relative Risk
- Odds Ratio
- Absolute Risk Reduction and Relative Risk Reduction
- Hazard Ratio
- Hypothesis and Significance Testing
- Confidence Intervals (CIs)
- How to Interpret a CI
- Probability and the Normal Curve
- Standard Deviation and Standard Error
- Sample Size Considerations
- Why Is Sample Size Important?
- Chapter 13. Issues of Bias and Confounding in Clinical Studies
- Introduction
- Confounding
- Control of Confounding
- Bias
- Bias in Therapy Studies
- Bias and Prognostic Studies
- Bias in Diagnostic Test Studies
- Conclusion
- Chapter 14. What Is Certainty of the Evidence, and Why Is It Important to Dental Practitioners?
- Introduction
- Certainty of the Evidence
- Criteria to Rate Down the Certainty of the Evidence
- Risk of Bias
- Inconsistency
- Imprecision
- Indirectness
- Population
- Intervention or diagnostic test strategy
- Outcome
- Publication Bias
- Criteria to Upgrade the Certainty of the Evidence
- Conclusion
- Chapter 15. Strategies for Teaching Evidence-Based Dentistry
- Introduction
- Curricular Outcomes
- Curricular Content
- Knowledge
- Scientific Evidence
- Behavior
- Application
- Professionalism
- Communication
- Instructional Methods
- Didactic Learning
- Application
- Clinical Activity
- Real-World Examples
- Virginia Commonwealth University School of Dentistry
- University of Texas Health Science Center San Antonio School of Dentistry
- Foundations
- Critically Appraised Topics (CATs)
- Evidence-Based Case Presentations
- Graduate-Level EBD Training Strategy
- FAST CATs Program: Academic Detailing
- Impact of the UTHSCSA School of Dentistry EBD/CATs Program
- Challenges
- University of Iowa College of Dentistry
- Overview
- Assessment
- Year 1 (D1)
- Year 2 (D2)
- Year 3 (D3)
- Year 4 (D4)
- Summary
- Competency Assessment
- Obstacles and Strategies
- Program Evaluation
- Accreditation Standards
- Adaptations for Nonacademic Settings
- Depth of Instruction
- Audiences beyond the Formal Educational Setting
- Conclusion
- Chapter 16. Implementing Evidence into Practice
- Defining the Scope of Implementation Science
- Translation of Scientific Evidence to Clinical Practice
- Four Phases of Implementation
- 1. Exploration
- Assessing the Need and Readiness for Change
- Understanding Issues and Theories of Behavior Change
- 2. Adoption Decision/Preparation
- Defining the Challenges and Barriers of Translating Best Evidence to Practice in Different Practice Settings
- Financial
- Clinical awareness
- Evidence-based dentistry skill
- Staff training
- Information technology issues
- Diagnostic codes
- Peer influence
- Policy issues
- Organizational barriers and facilitators
- 3. Active Implementation
- How to Implement a Clinical Practice Guideline in Various Dental Settings
- Step 1: Set an aim
- Step 2: Establish metrics
- Step 3: Identify the change
- Step 4: Test the change.
- Step 5: Implement the change.
- 4. Sustainment
- Establishing an Ongoing Process for Finding the Latest Evidence
- Issues in Program Sustainability
- Conclusion
- Chapter 17. Health Policymaking Informed by Evidence
- Introduction
- What Is Policy?
- Responsible Policy Development
- Types of Evidence Used in Health Policy
- Barriers to and Facilitators of Evidence-Informed Policymaking (EIPM)
- Strategies for Science Advocates in Promoting EIPM
- Strategies for Organizations in Engaging in EIPM
- Putting It All Together
- Conclusion
- Index
