02: Hujoel Article Flashcards
Who was the Primary author of the article?
Hujoel
What is the Name of the Article
Dental Flossing and Interproximal Caries: a Systematic Review
What type of Study was Conducted
Systematic Review
Abstract: What was the primary goal of the research?
To systematically assess the effect of flossing on INTERPROXIMAL caries risk
How many subjects were in the study?
808
What were the age ranges of the patients in the study?
4-13 Year
How many trials were completed?
6
When professional flossing was performed on school days for 1.7 years, what type of risk reduction was discovered?
40%
What is relative risk?
The probability of an event happening to an exposed group/ The probability of the event happening to non-exposed people
Can you give an example of RR?
Yes Lung Cancer is Smokers vs. Lung Cancer in Non-Smokers
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?
(20/100)/(2/100) = .2/.02 = 10
Smokers are 10 times more likely to get lung cancer
What information in the abstract tells us that results might show bias?
Professional flossing reduces caries risk, but unsupervised home flossing does not
According to research done in 1989 what is true about biofilm found in interproximal areas compared to other locations in the mouth?
It is more acidogenic
What was the hypothesis?
Dental Flossing reduces interproximal caries risk
What treatment comparisons were included?
Flossing v. No Flossing
Comparisons of different frequencies of flossing
What was the primary study outcome?
The measure of caries incidence
What databases were consulted for the search?
MEDLINE
Cochrane
What bit of information might have added some bias in terms of blinding?
The author states that blinding of the care provider and the subject was not applicable to our research question
In forest plots, how is the weight of each study determined?
By using the inverse of the variance
On average, what is the biggest determining factor in terms of how much weight a study receives
Its size
What do the horizontal lines on the forest plot indicate?
The 95% confidence interval
What is the vertical line in the forest plot?
The line of no effect
In Risk Ratios, the line of no effect is placed at a value of “1”. When would it be “0”?
When the results are a product of mean difference
What do the peaks of the “Meta” diamond indicate?
The point estimate
How can you tell if the results of a meta analysis are significant just by looking at the forest plot?
If the diamond (CI) crosses the line of no effect it means that the results are NOT significant
What is heterogeneity
Differences between studies that are not due to chance….apples vs. oranges
What is clinical heterogeneity
Differences in patients, study settings, interventions/outcomes This heterogeneity is impossible to eliminate
What is statistical heterogeneity
When individual trial have results that aren’t in sync with each other
What is blinding?
Keeping people unaware of treatment group assignment after randomization
Who in blinded in a single blinded test?
Patient only
Who is blinded in a double blind study?
Patient and Researchers
Who is blinded in a triple blind study
Patient
Researchers
Stats Assessor and assistants
What was the clearly focused question in the review?
Does flossing help reduce the incidence of interproximal caries?
CASP 2: Did the authors look for the right type of papers
Yes. They searched for RCT that fit their hypothesis criteria
CASP 3: Do you think all of the important, relevant studies were included?
Yes. The databases used were solid and they explained the search parameters
CASP 4: Did the authors do enough to assess the quality of the included studies?
Yes. The authors explained that the results reporting was typically poor and that there was evidence of bias
CASP 6: What were the overall results of the review?
That flossing showed a RR of 0.86 or 14% lower rate of interproximal caries with flossing
How are the CI’s?
variable
Can the results be applied to the local population?
Yes, but the study was performed on kids, not adults
