Lecture 1 Flashcards
What are Clinical Evaluative Sciences?
- Biostatistics
- Epidemiology
- Behavioral Science
- Health Economics
The purpose of this course is to make you a life-long learner capable of understanding the dental literature, and a practitioner who can objectively and scientifically apply evidence to evaluate and improve your practice
Goal of course
An approach to oral health care that requires the integration clinically relevant scientific evidence, relating to the patient’s oral and medical condition and history, with the dentist’s clinical expertise and the patient’s treatment needs and preferences
Evidence-Based Dentistry
Approach to practice and to making clinical decisions.
Patient-centered approach
3 components of Evidence based Dentistry
- The best available scientific evidence.
- A dentist’s clinical skill and judgment.
- Patient’s needs and preferences
Systematic approach to practicing good dentistry
EBD
Outcomes of EBD
- evaluation of science underlying clinical care
- quality of decision making
- reduction in variations in clinical practice
The application of the current best evidence in making decisions about the care of individual patients
Evidence-based practice
EBD steps
- Formulate
- Find
- Review
- Integrate
- Evaluate
____A clinically relevant question
Formulate
____ The best available evidence
Find
____ The evidence for its validity and applicability, strengths & weeknesses
Review
_____ the best research evidence with your clinical expertise and patient’s needs, desires, and values
Integrate
_____ your efforts and seek ways to improve (self-evaluate)
Evaluate
Anatomy of well formulated question
Population of Patient type
Intervention or Exposure
Comparison
Outsome
Persons for whom an answer is sought
Population or patient
Treatment or exposure related to the clinical condition of interest
Intervention or exposure
Alternative treatment or control condition
Comparison
Measure (s) used to assess effects
Outcome
What are the best levels of evidence?
Systematic reviews and RCT
Lowest levels of evidence
Case reports and expert opinions
- randomized controlled clinical trials
- non- randomized controlled trials, crossover studies
- cohort studies, case-control studies, cross-sectional studies
- case studies,
- the consensus opinion of experts
Where best evidence is obtained from
Is a comprehensive search for all relevant studies on a specific topic and those identified are then appraised and synthesized according to predetermined and explicit criteria
Systematic Literature Review
Synthesizes the best evidences and provides the basis for clinical practice guidelines.
Systematic Literature Review
Steps to follow a systematic literature review
- Identify questions to be examined.
- Determine the inclusion/exclusion criteria.
- Create a search strategy.
- Create criteria for study quality.
- Development of conclusions.
The body of writing in books, journals, reports and other sources that make the sum of knowledge.
Dental Literature
Most familiar source of information for students
Textbooks
Basic source of current information
Journals
What should a well written title maintain?
Informative, concise & attract interest
Should tell why the study was done, what was done, found and concluded
Abstract
States the problem and current state of knowledge
Introduction
Should be presented wit sufficient detail that the reader could repeat the investigation
Materials and methods
Presents the data in an organized manner
Results
contains the logical arguments linking the results to the work of other investigators.
Discussion
Presents the authors conclusions base on the evidence provided and taking into account potential limitations
Conclusion
