02: Hujoel Article

Question 1

Who was the Primary author of the article?

Answer 1

Hujoel

Question 2

What is the Name of the Article

Answer 2

Dental Flossing and Interproximal Caries: a Systematic Review

Question 3

What type of Study was Conducted

Answer 3

Systematic Review

Question 4

Abstract: What was the primary goal of the research?

Answer 4

To systematically assess the effect of flossing on INTERPROXIMAL caries risk

Question 5

How many subjects were in the study?

Answer 5

808

Question 6

What were the age ranges of the patients in the study?

Answer 6

4-13 Year

Question 7

How many trials were completed?

Answer 7

6

Question 8

When professional flossing was performed on school days for 1.7 years, what type of risk reduction was discovered?

Answer 8

40%

Question 9

What is relative risk?

Answer 9

The probability of an event happening to an exposed group/ The probability of the event happening to non-exposed people

Question 10

Can you give an example of RR?

Answer 10

Yes Lung Cancer is Smokers vs. Lung Cancer in Non-Smokers

Question 11

Say that 20 of 100 smokers had lung cancer and 2 of 100 smokers had lung cancer. What would the relative risk of getting lung cancer be in smokers vs. non-smokers?

Answer 11

(20/100)/(2/100) = .2/.02 = 10

Smokers are 10 times more likely to get lung cancer

Question 12

What information in the abstract tells us that results might show bias?

Answer 12

Professional flossing reduces caries risk, but unsupervised home flossing does not

Question 13

According to research done in 1989 what is true about biofilm found in interproximal areas compared to other locations in the mouth?

Answer 13

It is more acidogenic

Question 14

What was the hypothesis?

Answer 14

Dental Flossing reduces interproximal caries risk

Question 15

What treatment comparisons were included?

Answer 15

Flossing v. No Flossing

Comparisons of different frequencies of flossing

Question 16

What was the primary study outcome?

Answer 16

The measure of caries incidence

Question 17

What databases were consulted for the search?

Answer 17

MEDLINE

Cochrane

Question 18

What bit of information might have added some bias in terms of blinding?

Answer 18

The author states that blinding of the care provider and the subject was not applicable to our research question

Question 19

In forest plots, how is the weight of each study determined?

Answer 19

By using the inverse of the variance

Question 20

On average, what is the biggest determining factor in terms of how much weight a study receives

Answer 20

Its size

Question 21

What do the horizontal lines on the forest plot indicate?

Answer 21

The 95% confidence interval

Question 22

What is the vertical line in the forest plot?

Answer 22

The line of no effect

Question 23

In Risk Ratios, the line of no effect is placed at a value of “1”. When would it be “0”?

Answer 23

When the results are a product of mean difference

Question 24

What do the peaks of the “Meta” diamond indicate?

Answer 24

The point estimate

Question 25

How can you tell if the results of a meta analysis are significant just by looking at the forest plot?

Answer 25

If the diamond (CI) crosses the line of no effect it means that the results are NOT significant

Question 26

What is heterogeneity

Answer 26

Differences between studies that are not due to chance....apples vs. oranges

Question 27

What is clinical heterogeneity

Answer 27

Differences in patients, study settings, interventions/outcomes This heterogeneity is impossible to eliminate

Question 28

What is statistical heterogeneity

Answer 28

When individual trial have results that aren't in sync with each other

Question 29

What is blinding?

Answer 29

Keeping people unaware of treatment group assignment after randomization

Question 30

Who in blinded in a single blinded test?

Answer 30

Patient only

Question 31

Who is blinded in a double blind study?

Answer 31

Patient and Researchers

Question 32

Who is blinded in a triple blind study

Answer 32

Patient Researchers Stats Assessor and assistants

Question 33

What was the clearly focused question in the review?

Answer 33

Does flossing help reduce the incidence of interproximal caries?

Question 34

CASP 2: Did the authors look for the right type of papers

Answer 34

Yes. They searched for RCT that fit their hypothesis criteria

Question 35

CASP 3: Do you think all of the important, relevant studies were included?

Answer 35

Yes. The databases used were solid and they explained the search parameters

Question 36

CASP 4: Did the authors do enough to assess the quality of the included studies?

Answer 36

Yes. The authors explained that the results reporting was typically poor and that there was evidence of bias

Question 37

CASP 6: What were the overall results of the review?

Answer 37

That flossing showed a RR of 0.86 or 14% lower rate of interproximal caries with flossing

Question 38

How are the CI's?

Answer 38

variable

Question 39

Can the results be applied to the local population?

Answer 39

Yes, but the study was performed on kids, not adults