Skip to main content
SpringerLink
Log in

Translational Evidence-Based Interventions in Osteoimmunology

  • Chapter
  • First Online:
Osteoimmunopathology

  • 488 Accesses

Abstract

We began this monograph by citing an Evidence Report Publication (No. 07-E012) of the Agency for Healthcare Research and Quality (AHRQ). AHRQ plays a leadership role in the evolution of the field, from fundamental methodological issues to the design, establishment, verification, and dissemination of Registries. AHRQ defines Registries as: “… (a) patient registry is an organized system that uses observational study methods to collect uniform data (clinical and other) to evaluate specified outcomes for a population defined by a particular disease, condition, or exposure, and that serves one or more predetermined scientific, clinical, or policy purposes… registries (are) created for one or more of the following purposes: to describe the natural history of disease, to determine clinical effectiveness or costeffectiveness of health care products and services, to measure or monitor safety and harm, and/or to measure quality of care….(and) are classified according to how their (patient) populations are defined…” (Gliklich and Dreyer 2010).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Notes

  1. 1.

    “…for example, product registries include patients who have been exposed to biopharmaceutical products or medical devices. Health services registries consist of patients who have had a common procedure, clinical encounter, or hospitalization. Disease or condition registries are defined by patients having the same diagnosis, such as cystic fibrosis or heart failure…” (Gliklich and Dreyer 2010).

  2. 2.

    For example, the purpose of registries may include “…internal, external, or historical comparison groups in order to strengthen the understanding of whether the observed effects are indeed real and in fact ­different from what would have occurred under other circumstances…” (Gliklich and Dreyer 2010).

  3. 3.

    AHRQ, for example, refers to evidence reports; whereas the American Dental Association, for instance, uses the term evidence reviews.

  4. 4.

    The interested reader is advised to get on the mailing list of the Cochrane journal club (http://www.cochranejournalclub.com).

  5. 5.

    Some degree of selection bias is unavoidable because of the very nature of our peer-review system. For example, a certain degree of publication bias cannot be avoided simply because, as a general rule, papers that are statistically significant, whether they demonstrate clinical relevance or not, tend to be prefentially published in the scientific literature, compared to reports that demonstrate clinical relevance but fail to reach statistical significance. The problem of publication bias is inherent to our present system of scientific literature, and is an unavoidable issue of the research synthesis process. The effect of the preferential acceptance of articles reporting significant results on research is critical: bias in favor of studies showing significant results alter the reliability of systematic reviews by reducing the included number of papers with opposing results. Since the validity of this type of publications depends on the representativeness and soundness of the source material, underrepresented evidence will have a disproportionally decreased influence on the outcome. That will be particularly grave when, as is the case for instance in osteoimmunology, research synthesis is utilized to obtain the best available evidence for treatment of pathologies in order to perform either evidence-based clinical decisions, or comparative effectiveness analysis (cf., Chiappelli et al. 2010a, b).

  6. 6.

    It is important to note that inter-rater reliability obtains a correlation coefficient between two raters, and a high correlation implies that the two raters “agreed” on which item to score high or low (i.e., strong positive Pearson correlation coefficient). By contrast, Cohen’s kappa coefficient is a statistical measure of agreement, which assesses whether or not the probability of the raters agreeing is larger than chance alone. That is to say, the Pearson intra-rater reliability coefficient is distinct from Cohen’s kappa coefficient, although both values establish the degree of agreement between two raters, they are two distinct sides of the same coin.

  7. 7.

    The Institute of Medicine Committee on Comparative Effectiveness Research Prioritization defined (2009) comparative effectiveness research and analysis as “the generation and synthesis of evidence that compares the benefits and harms of alternative methods to prevent, diagnose, treat, and monitor a clinical condition or to improve the delivery of care. The purpose of CER is to assist consumers, clinicians, purchasers, and policy makers to make informed decisions that will improve health care at both the individual and population levels.”

  8. 8.

    For example, the interested reader is referred to a recent AHRQ report: Creating a Framework for “Best Evidence” Approaches in Systematic Reviews, Review Protocol. September 2010. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/clinic/tp/bestevtp.htm.

  9. 9.

    Fundamentally, and as defined by the National Institutes of Health (NIH), translational research is used to translate the findings in basic research efficiently into clinical practice.

  10. 10.

    The clinically relevant complex mixed systematic reviews (CRCMSRs) combine (i.e., “mix”) the traditional systematic review approach outlined above with the systematic reviews performed on a set of systematic reviews (i.e., CRCSRs). That mixing of two heterogeneous bodies of research in a single research synthesis process engenders significant analytical challenges and interpretative difficulties, which are still under development by my research group and others.

  11. 11.

    These limitations emphasize the need for assessment of the level of the evidence and of the quality of the evidence, followed by an acceptable sampling step, as described above (vide supra).

  12. 12.

    The CONSORT statement has recently been revised as CONSORT-2010 (vide infra).

References

  • Ajaj RA, Barkhordarian A, Phi L, Giroux A, Chiappelli F. Evidence-Based Dentistry: The Next Frontier in Translational and Trans-National Dental Practice. Dental Hypotheses. 2011 2:55–62.

    Google Scholar 

  • Alagoz O, Hsu H, Schaefer AJ, Roberts MS. Markov decision processes: a tool for sequential decision making under uncertainty. Med Decis Making. 2010 30:474–83.

    Article  PubMed  Google Scholar 

  • Andronis L, Barton P, Bryan S. Sensitivity analysis in economic evaluation: An audit of NICE current practice and a review of its use and value in decision-making. Health Technol Assess. 2009 iii, ix-xi: 1–61.

    Google Scholar 

  • Arrich J, Piribauer F, Mad P, Schmid D, Klaushofer K, Müllner M. Intra-articular hyaluronic acid for the treatment of osteoarthritis of the knee: systematic review and meta-analysis. CMAJ 2005 172:1039–43.

    Article  PubMed  Google Scholar 

  • Atieh MA, Ibrahim HM, Atieh AH. Platform Switching for Marginal Bone Preservation Around Dental Implants: A Systematic Review and Meta-Analysis. J Periodontol. 2010 81(10):1350–66.

    Article  PubMed  Google Scholar 

  • Begg C, Cho M, Eastwood S, Horton R, Moher D, Olkin I, Pitkin R, Rennie D, Schulz KF, Simel D, Stroup DF. Improving the quality of reporting of randomized controlled trials. The CONSORT statement. JAMA. 1996 276:637–9.

    Article  PubMed  CAS  Google Scholar 

  • Bellamy N, Campbell J, Robinson V, Gee T, Bourne R, Wells G. Viscosupplementation for the treatment of osteoarthritis of the knee. Cochrane Database Syst Rev. 2005 18:CD005321.

    Google Scholar 

  • Bolland MJ, Grey AB, Gamble GD, Reid IR. Effect of osteoporosis treatment on mortality: a meta-analysis. J Clin Endocrinol Metab. 2010 95:1174–81.

    Article  PubMed  CAS  Google Scholar 

  • Boonen S, Laan RF, Barton IP, Watts NB. Effect of osteoporosis treatments on risk of non-vertebral fractures: review and meta-analysis of intention-to-treat studies. Osteoporos Int. 2005 16:1291–8.

    Article  PubMed  Google Scholar 

  • Breslau ES, Rochester PW, Saslow D, Crocoll CE, Johnson LE, Vinson CA. Developing partnerships to reduce disparities in cancer screening. Prev Chronic Dis. 2010 7:A62.

    PubMed  Google Scholar 

  • Brouwers MC, Kho ME, Browman GP, Burgers JS, Cluzeau F, Feder G, Fervers B, Graham ID, Hanna SE, Makarski J. AGREE Next Steps Consortium. Development of the AGREE II, part 1: performance, usefulness and areas for improvement. CMAJ. 2010a 182:1045–52

    Article  PubMed  Google Scholar 

  • Brown TT, Qaqish RB. Antiretroviral therapy and the prevalence of osteopenia and osteoporosis: a meta-analytic review. AIDS. 2006 20:2165–74.

    Article  PubMed  Google Scholar 

  • Brozek JL, Akl EA, Jaeschke R, Lang DM, Bossuyt P, Glasziou P, Helfand M, Ueffing E, Alonso-Coello P, Meerpohl J, Phillips B, Horvath AR, Bousquet J, Guyatt GH, Schünemann HJ. GRADE Working Group. Grading quality of evidence and strength of recommendations in clinical practice guidelines: Part 2 of 3. The GRADE approach to grading quality of evidence about diagnostic tests and strategies. Allergy. 2009 64:1109–16.

    Article  PubMed  CAS  Google Scholar 

  • Brzusek D, Petron D. Treating knee osteoarthritis with intra-articular hyaluronans. Curr Med Res Opin. 2008 24:3307–22.

    Article  PubMed  CAS  Google Scholar 

  • Burkiewicz JS, Scarpace SL, Bruce SP. Denosumab in osteoporosis and oncology. Ann Pharmacother. 2009 43:1445–55.

    Article  PubMed  CAS  Google Scholar 

  • Chang EJ, Kim HJ, Ha J, Kim HJ, Ryu J, Park KH, Kim UH, Lee ZH, Kim HM, Fisher DE, Kim HH. Hyaluronan inhibits osteoclast differentiation via Toll-like receptor 4. J Cell Sci. 2007 120:166–76.

    Article  PubMed  CAS  Google Scholar 

  • Chiappelli F, Ramchandani MH, Phi L, Brant XMC. Clinically Relevant Complex Systematic Reviews in Endodontics: Relevance to Comparative Effectiveness Research and Evidence-Based Clinical Decision-Making. In F. Chiappelli & Brant XMC (Eds.) Comparative Effectiveness Research and Evidence-Based Health Care in Endodontics. Bentham Science, E-books, 2010, Chapter 1.

    Google Scholar 

  • Chiappelli F. Future Avenues of Research Synthesis for Evidence-Based Clinical Decision Making. In Chiappelli F. Brant XMC, Oluwadara OO, Neagos N, Ramchandani MH. (Eds.) Understanding Evidence-Based Practice: Toward Optimizing Clinical Outcomes. Springer, Heidelberg 2010, Chap 15.

    Google Scholar 

  • Chiappelli F. The Science of Research Synthesis: A Manual of Evidence-Based Research for the Health Sciences – Implications and Applications in Dentistry. NovaScience Publisher, Inc., 2008. pp. 1–327.

    Google Scholar 

  • Chiappelli F, Cajulis OS. The logic model in evidence-based clinical decision-making in dental practice. J Evid Based Dent Pract 2009 9:206–10.

    Article  PubMed  Google Scholar 

  • Chiappelli F, Cajulis O, Newman M. Comparative Effectiveness Research in Evidence‐Based Dental Practice. J Evid Based Dent Pract 2009 9:57–8.

    Article  PubMed  Google Scholar 

  • Day AJ, de la Motte CA. Hyaluronan cross-linking: a protective mechanism in inflammation? Trends Immunol. 2005 26:637–43.

    Google Scholar 

  • de la Motte C, Nigro J, Vasanji A, Rho H, Kessler S, Bandyopadhyay S, Danese S, Fiocchi C, Stern R. Platelet-derived hyaluronidase 2 cleaves hyaluronan into fragments that trigger monocyte-mediated production of proinflammatory cytokines. Am J Pathol. 2009 174:2254–64.

    Article  PubMed  Google Scholar 

  • Dittus RS, Roberts SD, Wilson JR. Quantifying uncertainty in medical decisions. J Am Coll Cardiol. 1989 14:S23A–8A.

    Google Scholar 

  • Donaldson NE, Rutledge DN, Ashley J. Outcomes of adoption: measuring evidence uptake by individuals and organizations. Worldviews Evid Based Nurs. 2004 1S:41–51.

    Article  Google Scholar 

  • Escalas C, Trijau S, Dougados M. Evaluation of the treatment effect of NSAIDs/TNF blockers according to different domains in ankylosing spondylitis: results of a meta-analysis. Rheumatology (Oxford). 2010 49:1317–25.

    Article  CAS  Google Scholar 

  • Faggion CM Jr. Grading the quality of evidence and the strength of recommendations in clinical dentistry: a critical review of 2 prominent approaches. J Evid Based Dent Pract. 2010 10:78–85.

    Article  PubMed  Google Scholar 

  • Gliklich RE, Dreyer NA, Eds. Registries for Evaluating Patient Outcomes: A User’s Guide. 2nd ed. (Prepared by Outcome DEcIDE Center [Outcome Sciences, Inc. d/b/a Outcome] under Contract HHSA29020050035I TO3.) AHRQ Pub. 10-EHC049. Rockville, MD: Agency for Healthcare Research and Quality. September 2010.

    Google Scholar 

  • Goeree R, Blackhouse G, Adachi J. Cost-effectiveness of alternative treatments for women with osteoporosis in Canada. Curr Med Res Opin. 2006 22:1425–36.

    Article  PubMed  Google Scholar 

  • Graudal N, Jürgens G. Similar effects of disease modifying anti rheumatic drugs, glucocorticoids and biologics on radiographic progression in rheumatoid arthritis: meta-analysis of 70 randomized placebo or drug controlled studies including 112 comparisons. Arthritis Rheum. 2010 62(10):2852–63.

    Article  PubMed  CAS  Google Scholar 

  • Hardy ML, Coulter I, Morton SC, Favreau J, Venuturupalli S, Chiappelli F, Rossi F, Orshansky G, Jungvig LK, Roth EA, Suttorp MJ, Shekelle P. S-adenosyl-L-methionine for treatment of depression, osteoarthritis, and liver disease. Evid Rep Technol Assess 2003 64:1–3.

    Google Scholar 

  • Helfrich CD, Li YF, Sharp ND, Sales AE. Organizational readiness to change assessment (ORCA): development of an instrument based on the Promoting Action on Research in Health Services (PARiHS) framework. Implement Sci. 2009 4:38.

    Article  PubMed  Google Scholar 

  • Hoffman SJ, Lavis JN, Bennett S. The Use of Research Evidence in Two International Organizations’ Recommendations about Health Systems. Health Pol 2009 5:66–86.

    Google Scholar 

  • Jackson DG. Immunological functions of hyaluronan and its receptors in the lymphatics. Immunol Rev. 2009 230:216–31.

    Article  PubMed  CAS  Google Scholar 

  • Jüni P, Egger M. PRISMAtic reporting of systematic reviews and meta-analyses. Lancet. 2009 374:1221–3.

    Article  PubMed  Google Scholar 

  • Kitson AL, Rycroft-Malone J, Harvey G, McCormack B, Seers K, Titchen A. Evaluating the successful implementation of evidence into practice using the PARiHS framework: theoretical and practical challenges. Implement Sci. 2008 3:1.

    Article  PubMed  Google Scholar 

  • Kung J, Chiappelli F, Cajulis OS, Avezova R, Kossan G, Chew L, Maida CA. From Systematic Reviews to Clinical Recommendations for Evidence-Based Health Care: Validation of Revised Assessment of Multiple Systematic Reviews (R-AMSTAR) for Grading of Clinical Relevance. The Open Dentistry Journal 2010, 4:84–91.

    PubMed  Google Scholar 

  • Lachin JM. Statistical Considerations in the Intent-to-Treat Principle. Controlled Clinical Trials 2000, 21:167–18.

    Article  PubMed  CAS  Google Scholar 

  • Levy AG, Hershey JC. Value-induced bias in medical decision making. Med Decis Making. 2008 28:269–76.

    Article  PubMed  Google Scholar 

  • Li B, Wang P, Li H. The association between TNF-alpha promoter polymorphisms and ankylosing spondylitis: a meta-analysis. Clin Rheumatol. 2010 29:983–90.

    Article  PubMed  CAS  Google Scholar 

  • Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP, Clarke M, Devereaux PJ, Kleijnen J, Moher D. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Med. 2009 6:e1000100.

    Article  PubMed  Google Scholar 

  • Lin D, Rieder MJ. Interventions for the treatment of decreased bone mineral density associated with HIV infection. Cochrane Database Syst Rev. 2007 18:CD005645.

    Google Scholar 

  • Lin KW, Slawson DC. Identifying and using good practice guidelines. Am Fam Physician. 2009 80:67–70.

    PubMed  Google Scholar 

  • Little J, Higgins JP, Ioannidis JP, Moher D, Gagnon F, von Elm E, Khoury MJ, Cohen B, Davey-Smith G, Grimshaw J, Scheet P, Gwinn M, Williamson RE, Zou GY, Hutchings K, Johnson CY, Tait V, Wiens M, Golding J, van Duijn C, McLaughlin J, Paterson A, Wells G, Fortier I, Freedman M, Zecevic M, King R, Infante-Rivard C, Stewart A, Birkett N. STrengthening the REporting of Genetic Association studies (STREGA): an extension of the STROBE Statement. Ann Intern Med. 2009 150:206–15

    PubMed  Google Scholar 

  • Macdonald-Jankowski DS. Focal cemento-osseous dysplasia: a systematic review. Dentomaxillofac Radiol. 2008 37:350–60.

    Article  PubMed  CAS  Google Scholar 

  • MacDonald-Jankowski DS. Ossifying fibroma: a systematic review. Dentomaxillofac Radiol. 2009 38:495–513.

    Article  PubMed  CAS  Google Scholar 

  • MacPherson H, Altman DG, Hammerschlag R, Youping L, Taixiang W, White A, Moher D. STRICTA Revision Group. Revised STandards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA): extending the CONSORT statement. PLoS Med. 2010 7:e1000261.

    Article  PubMed  Google Scholar 

  • Manheimer E, Cheng K, Linde K, et al. Acupuncture for peripheral joint osteoarthritis. Cochrane Database Syst Rev 2010 (1):CD001977.

    Google Scholar 

  • McLeod C, Bagust A, Boland A, Dagenais P, Dickson R, Dundar Y, Hill RA, Jones A, Mujica Mota R, Walley T. Adalimumab, etanercept and infliximab for the treatment of ankylosing spondylitis: a systematic review and economic evaluation. Health Technol Assess. 2007 11:1–158, iii-iv.

    Google Scholar 

  • Menezes GB, McAvoy EF, Kubes P. Hyaluronan, platelets, and monocytes: a novel pro-inflammatory triad. Am J Pathol. 2009 174:1993–5.

    Article  PubMed  CAS  Google Scholar 

  • Migliore A, Giovannangeli F, Bizzi E, Massafra U, Alimonti A, Laganà B, Diamanti Picchianti A, Germano V, Granata M, Piscitelli P. Viscosupplementation in the management of ankle osteoarthritis: a review. Arch Orthop Trauma Surg. 2011 131:139–47.

    Google Scholar 

  • Mobley LR, Hoerger TJ, Wittenborn JS, Galuska DA, Rao JK. Cost-effectiveness of osteoporosis screening and treatment with hormone replacement therapy, raloxifene, or alendronate. Med Decis Making. 2006 26:194–206.

    Article  PubMed  Google Scholar 

  • Moher D, Cook DJ, Eastwood S, Olkin I, Rennie D, Stroup DF. Improving the quality of reports of meta-analyses of randomised controlled trials: the QUOROM statement. Quality of Reporting of Meta-analyses. Lancet. 1999 354:1896–900.

    Article  PubMed  CAS  Google Scholar 

  • Montori VM, Guyatt GH. Progress in evidence-based medicine. JAMA 2008 300:1814–6.

    Article  PubMed  CAS  Google Scholar 

  • Oakley JE, O’Hagan A. Probabilistic sensitivity analysis of complex models: a Bayesian approach. JR Statist Soc B 2004 66:751–69.

    Article  Google Scholar 

  • Ogilvie D, Craig P, Griffin S, Macintyre S, Wareham NJ. A translational framework for public health research. BMC Public Health. 2009 9:116.

    Article  PubMed  Google Scholar 

  • Pazianas M, Miller P, Blumentals WA, Bernal M, Kothawala P. A review of the literature on osteonecrosis of the jaw in patients with osteoporosis treated with oral bisphosphonates: prevalence, risk factors, and clinical characteristics. Clin Ther. 2007 29:1548–58.

    Article  PubMed  CAS  Google Scholar 

  • Prochaska JO, Decision Making in the Transtheoretical Model of Behavior Change. Med Decis Making 2008 28:845–9.

    Article  PubMed  Google Scholar 

  • Reyna VF, A Theory of Medical Decision Making and Health: Fuzzy Trace Theory. Med Decis Making 2008 28:850–65

    Article  PubMed  Google Scholar 

  • Schulz KF, Altman DG, Moher D, CONSORT Grp. CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. PLoS. Med. 2010 7:e1000251.

    Google Scholar 

  • Schünemann HJ, Oxman AD, Brozek J, Glasziou P, Bossuyt P, Chang S, Muti P, Jaeschke R, Guyatt GH. GRADE: assessing the quality of evidence for diagnostic recommendations. Evid Based Med. 2008 13:162–3.

    Article  PubMed  Google Scholar 

  • Shea BJ, Grimshaw JM, Wells GA, Boers M, Andersson N, Hamel C, Porter AC, Tugwell P, Moher D, Bouter LM. Development of AMSTAR: a measurement tool to assess the methodological quality of systematic reviews. BMC Med Res Methodol. 2007 7:10

    Article  PubMed  Google Scholar 

  • Shi H, Lyons-Weiler J. Clinical decision modeling system. BMC Med Inform Decis Mak. 2007 7:23.

    Article  PubMed  CAS  Google Scholar 

  • Simera I, Moher D, Hoey J, Schulz KF, Altman DG. The EQUATOR Network and reporting guidelines: Helping to achieve high standards in reporting health research studies. Maturitas. 2009 63:4–6.

    Article  PubMed  Google Scholar 

  • Simon D, Loh A, Härter M. Measuring (shared) decision-making – a review of psychometric instruments. Z Arztl Fortbild Qualitatssich. 2007 101:259–67.

    PubMed  Google Scholar 

  • Spring B. Health Decision Making: Lynchpin of Evidence-Based Practice. Med Decis Making 2008 28:866–74.

    Google Scholar 

  • Stevenson M, Jones ML, De Nigris E, Brewer N, Davis S, Oakley J. A systematic review and economic evaluation of alendronate, etidronate, risedronate, raloxifene and teriparatide for the prevention and treatment of postmenopausal osteoporosis. Health Technol Assess. 2005 9:1–160.

    PubMed  CAS  Google Scholar 

  • Terracciano L, Brozek J, Compalati E, Schünemann H. GRADE system: new paradigm. Curr Opin Allergy Clin Immunol. 2010 10:377–83

    Article  PubMed  Google Scholar 

  • Thelle DS. STROBE and STREGA: Instruments for improving transparency and quality of reporting scientific results. Eur J Epidemiol. 2009 24:7–8.

    Article  PubMed  Google Scholar 

  • Titler MG. Methods in translation science. Worldviews Evid Based Nurs. 2004 1:38–48.

    Article  PubMed  Google Scholar 

  • von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. STROBE Initiative. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE)statement: guidelines for reporting observational studies. Lancet. 2007 370:1453–7.

    Article  Google Scholar 

  • West SL, Gartlehner G, Mansfield AJ, Poole C, Tant E, Lenfestey N, Lux LJ, Amoozegar J, Morton SC, Carey TC, Viswanathan M, Lohr KN. Clinical Heterogeneity. In: AHRQ Report 10-EHC-070 EF: Comparative Effectiveness Review Methods. Rockville, MD. 2010.

    Google Scholar 

  • Whitney SN, Holmes-Rovner M, Brody H, Schneider C, McCullough LB, Volk RJ, McGuire AL. Beyond shared decision making: an expanded typology of medical decisions. Med Decis Making. 2008 28:699–705.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. School of Dentistry Division of Oral Biology & Medicine, University of California at Los Angeles, Los Angeles, California, USA

    Professor Francesco Chiappelli Ph.D. (President)

  2. American Association of Oral Biologists Evidence-Based Dentistry Champion, American Dental Association, Los Angeles, California, USA

    Professor Francesco Chiappelli Ph.D. (President)

Authors
  1. Professor Francesco Chiappelli Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Francesco Chiappelli Ph.D. .

Rights and permissions

Reprints and permissions

Copyright information

© 2011 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Chiappelli, F. (2011). Translational Evidence-Based Interventions in Osteoimmunology. In: Osteoimmunopathology. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-9495-0_3

Download citation

Publish with us

Policies and ethics

Search

Navigation