Lecture 1 Flashcards
what are the 4 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
how to choose best information? the question becomes how should you decide which are the best procedures and techniques so you may provide the
best patient care
the dental profession must seek
continuing professional development and be exposed to the info. explosion and the consumer movement
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 ___ and the patient’s ___
evidence-based dentistry
the dentist’s clinical expertise and the patient’s treatment needs and preferences
evidence based dentistry takes a ___ approach
patient-centered
evidence based dentistry is based on 3 important components
- the best available scientific evidence
- a dentist’s clinical skill and judgement
- patient’s needs and preferences
EBD is a ___ approach to practicing good dentistry to help practitioners (1-3)
systematic
help practitioners provide the right care, to the right patients, at the right time
EBD is NOT
cook book dentistry
a standard of care
only about randomized trials
impossible to practice
EBD (will/will not) tell what practitioners should or should not do
will not
EBD process (is or is not) a rigid methodological evaluation of scientific evidence
is not
EBD outcome
better quality of patient care
EBD can facilitate, but does not guarantee
making better decisions in the provision of dental care
the application of the current best evidence in making decisions about the care of the individual patients
evidence based practice
Sackett, 1996
Evidence based dentistry steps: (5 of them)
- formulate a clinically relevant question
- find the best available evidence
- review the evidence for its validity, applicability, strengths, and weaknesses
- integrate the best research evidence with your clinical expertise and patient’s needs, desires, values
- evaluate your efforts and seek ways to improve (self-evaluate)
anatomy of well formulated question:
1= persons for whom an answer is sought
2= treatment or exposure related to the clinical condition of interest
3) alternative treatment or control condition
4. measure(s) used to assess effects
1= populations or patient type
2=intervention or exposure
3=comparison
4=outcome
we generally accept that __ and __ are the best levels of evidence
systematic reviews and randomized control trials
__ and __ are in the lowest level of evidence
case reports and expert opinions
with regards to diagnosis, prognosis or causation, longitudinal studies such as __ are appropriate
cohort studies
judging the quality of information, “best evidence” can be obtained from
- RCT
- cohort studies, case-control, and nonrandomized clinical studies
- cross-sectional studies
- descriptive surveys
- case reports
- personal opinion
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
to conduct a __ we must follow these steps:
synthesizes the best evidences and provides the basis for clinical practice guidelines
systematic literature review
these practice guidelines give a brief review of what EBD is and how to use it
systematic literature review
\+ID questions to be examined \+determine the inclusion/exclusion criteria \+create a search strategy \+create criteria for study quality \+development of conclusions
to conduct a systematic review
__ is the use of current best evidence in making decisions about care of the individual patients
EBD
EBD requires the practitioner to
question and think about what they are doing
information needs to be __ and its validity determined
assessed
the body of wiriting in books, journals, reports and other sources that make the sum of knowledge
dental literature
__ are the basic source of current information
journals
components of a scienctific paper
\+title,author \+date of submissions and acceptance \+abstract or summary \+introduction \+materials and mathods \+results \+discussion \+conclusions
a well written title should be
informative, concise, and 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 with 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
by formulating a clinical __, carrying out an efficient __, evaluating the literature, and when appropriate, applying it to patient care, dentists can meet the challenges of continuing to provide quality care in a rapidly changing environment
question
literature search
