Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Dental public health > 5- The role of clinical guidelines > Flashcards

5- The role of clinical guidelines Flashcards

1
Q

what are clinical guidelines?

A

Systematically developed recommendations on how healthcare and other professionals should care for people with specific conditions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what are national institute for health and care excellence (NICE) clinical guidelines?

A
  • Systematically developed recommendations on how healthcare and other professionals should care for people with specific conditions
  • Based on the best available evidence
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what are Scottish intercollegiate guidelines network (SIGN) guidelines?

A
  • Derived from a systematic review of the scientific literature
  • Aimed to accelerate the translation of new knowledge into action
  • Aim to reduce variations in practice
  • Improve patient-important outcomes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Name 3 organisations that produce guidelines.

A
  • British Dental Journal
  • European Commission
  • General Dental Council (GDC)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How do we rate the quality of a guideline?

A
  • the potential benefits of practice guidelines are only as good as the quality of the guidelines themselves
  • it is important to assess the methods used to develop practice guidelines in order to be confident of the resulting recommendations
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What should high quality guidelines be?

A
  • based on the best available evidence
  • have a clear scope and purpose
  • demonstrate methodological rigour
  • be free from bias
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is a systemic review?

A

A replicable, scientific, and transparent process

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what do a systemic review do?

A

A systematic review summarises the results of available carefully designed healthcare studies (controlled trials) and provides a high level of evidence on the effectiveness of healthcare interventions. Judgments may be made about the evidence and inform recommendations for healthcare

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is a benefit of a systemic review?

A

It reduces researcher bias and demands the researcher is comprehensive in their approach

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what are other benefits of a systematic review?

A
  • Can end confusion
  • Yield new insights by combining findings from different studies
  • Highlights where there is not enough evidence
  • When there is enough evidence can reduce the influence of flawed single studies
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Name the features of a good systemic review.

A
  • Based on scientifically rigorous methods
  • Answers a defined research question
  • Searches all relevant sources of peer reviewed published studies and checks for unpublished studies
  • Includes and reports pre-established quality control guidelines for studies
  • Transparency and replicability of methods
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is the transparency of a systemic review?

A
  • What search terms were used?
  • What data sources were searched?
  • What studies were excluded and why?
  • What period was covered?
  • Any conflict of interests?
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

True or false -A meta -analysis combine the results of individual studies in a systemic review to produce an overall statistic?

A

True or false - check with someone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is a meta-analysis?

A

A meta-analysis combines results of individual studies in a systematic review to produce an overall statistic i.e. the ‘average result’.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is the aim of meta-analysis?

A
  • Provide a more precise estimate of the effects of an intervention
  • to reduce uncertainty
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what diagram can results of a meta-analysis be put on?

A

Forest plot

17
Q

what does the solid vertical line in the centre of a first plot represent?

A

the line of no effect

18
Q

what are the limitations of systemic reviews and meta-analyses?

A
  • In a ‘hot’ subject may soon become outdated
  • May be poorly conducted or reported
  • May only have weak or biased Randomised Control Trials (RCTs) included
  • May be Anglo-centric
  • May ignore/under-represent grey literature
  • May be weakened by ‘heterogeneity’ of RCTs
19
Q

How good is the review?

A

-The Grading of Recommendations Assessment, Development
and Evaluation (GRADE) is a system for rating quality of evidence and
strength of recommendations
- Critical Appraisal Skills Program (CASP)
a methodological checklist which provides key criteria
relevant to systematic reviews

20
Q

True or false- clinical guidelines are an essential part of evidence based practice?

A

True

21
Q

what are the components of evidence based dentistry?

A
  • Dentists expertise
  • Scientific evidence
  • Patient needs and preferences
22
Q

What if there are no (high quality) Systematic Reviews?

A
  • Guideline recommendations can be based on expert opinion…..
  • Are recommendations based on expert opinion as good as those based on evidence from one or more high quality systematic reviews?
  • Do guidelines differentiate between recommendations based on ‘high quality’ evidence and those based on ‘low quality’ evidence?
23
Q

What should high quality clinical guidelines include?

A
  • Have clear scope and purpose
  • Be evidence- based (best available evidence that has been quality appraised)
  • Include end-users and patients in the development
  • Developed by a group of qualified individuals
  • Communicate the strength of recommendations (GRADE)
  • Presented in clear, unambiguous language
  • Be free from bias
  • Subject to public consultation
24
Q

What did a review by the NHS centre for reviews and dissemination conclude?

A

There appears to be little justification for the removal of pathology-free impacted third molars

25
Q

What is SDCEP?

A

The Scottish Dental Clinical Effectiveness Programme (SDCEP) is part of the Dental Directorate within NHS Education for Scotland

26
Q

what does SDCEP do?

A
  • develops guidance on priority topics for oral health care that aims to be evidence-based, practical and user friendly to support quality care
  • guidance informs under-graduate and post- graduate education and training as well as daily dental practice in Scotland and beyond
  • involved in implementation research to understand how to bring about changes in practice Healthier
27
Q

True or false - One of the most frequent dental procedures carried out in Scotland is the simple supra-gingival scale and polish?

A

True

28
Q

True or false -<10% of patients receive the more intensive
categories of care designated for managing patients
with moderate to severe disease?

A

True

29
Q

True or false -Medico-legal defense unions report that an increasing number of claims relate to alleged failure to diagnose and treat periodontitis?

A

True

30
Q

What areas does guidance provide evidence - based recommendations?

A
  • Assessment
  • Diagnosis
  • Changing Patient Behaviour
  • Maintaining Dental Implants
  • Referral
  • Providing Treatment
  • Record Keeping
  • Long Term Maintenance
31
Q

Clinical questions should follow the PICO format. What is the ‘P’ in this?

A

Patient, Population, or Problem

32
Q

what is P.I.C.O model for clinical questions?

A

Patient, Population, or Problem:
How would I describe a group of patients similar to mine?

Intervention, Prognostic Factor, or Exposure :
Which main intervention, prognostic factor, or exposure am I considering?

Comparison or Intervention (if appropriate) :
What is the main alternative to compare with the intervention?

Outcome you would like to measure or achieve :
What can I hope to accomplish, measure, improve, or affect?

33
Q

Give an example of what PICO format should clinical questions follow?

A

In patients with chronic periodontitis(P) , does the use of disinfectants during sub-gingival instrumentation (I), compared with sub-gingival instrumentation alone (C), result in improved periodontal health(O)?

34
Q

Give the evidence summary.

A

“The evidence, based on four systematic reviews, indicates that use of disinfectants during sub-gingival instrumentation does not result in any additional gains in terms of clinical outcomes compared with sub-gingival instrumentation alone. The evidence is considered low quality due to concerns about the quality of the primary studies, the heterogeneity in both the treatments studied and the design of the studies and the possible risk of bias.”

35
Q

Does the SDCEP guidance support adjunctive use of disinfectants during sub-gingival instrumentation?

A

No

36
Q

what is the considered judgement and guidance recommendation?

A

The evidence does not support the adjunctive use of disinfectants during sub-gingival instrumentation and the guidance development group does not recommend this for the routine treatment of chronic periodontitis

Dental public health (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions