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A Model for Implementing Evidence-Based Decisions in Dental Practice

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Evidence-Based Practice: Toward Optimizing Clinical Outcomes

Abstract

We describe the use of three checklists (CASP, QUOROM, and AMSTAR) to assess the methodological quality of two systematic reviews (SRs) of randomized controlled trials (RCTs) regarded as the strongest form of evidence. All three checklists showed both SRs were well-produced, although most of the RCTs included in both SRs contained several methodological limitations. A practical tool, in the form of decision tree, is presented to help dental clinicians to apply the evidence. We have also added information about two systems (GRADE and SORT) for assessing the quality of evidence and the strength of recommendations. We also briefly describe important concepts in the evaluation of the economics of dental treatment. Although these last two topics were not included in the EB model, they should be incorporated and further evaluated in a future, improved EB model.

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References

  1. American Dental Association. Survey Publications (2009) Vol. 1 Academic Programs, Enrollment and Graduates. Available online at: http://www.ada.org/ada/prod/survey/publications_educational.asp#series

  2. Vasak C, Fiederer R, Watzek G (2007) Current state of training for implant dentistry in Europe: a questionnaire-based survey. Clin Oral Implants Res 18(5):following 668

    Article  Google Scholar 

  3. Spencer JA, Jordan RK (1999) Learner centred approaches in medical education. BMJ 318(7193):1280–1283

    Article  PubMed  CAS  Google Scholar 

  4. Faggion CM Jr. & Schmitter M (2010) Making appropriate evidence-based clinical decisions in implant dentistry, using treatment of peri-implantitis as an example. Int J Oral Maxillofac Implants forthcoming

    Google Scholar 

  5. Bland M (2000) An introduction to medical statistics. Oxford University Press, Oxford

    Google Scholar 

  6. Bulman JS, Osborn JF (2002) Statistics in dentistry. BDJ Books, London

    Google Scholar 

  7. Staunton M (2007) Evidence-based radiology: steps 1 and 2–asking answerable questions and searching for evidence. Radiology 242(1):23–31

    Article  PubMed  Google Scholar 

  8. Moher D, Cook DJ, Eastwood S et al (1999) Improving the quality of reports of meta-analyses of randomised controlled trials: the QUOROM statement. Quality of reporting of meta-analyses. Lancet 354(9193):1896–1900

    CAS  Google Scholar 

  9. Shea BJ, Bouter LM, Peterson J et al (2007) External validation of a measurement tool to assess systematic reviews (AMSTAR). PLoS ONE;2(12):e1350

    Article  PubMed  Google Scholar 

  10. Fleiss J (1986) The design and analysis of clinical experiments. Wiley, New York

    Google Scholar 

  11. Kotsovilis S, Karoussis IK, Trianti M, Fourmousis I (2008) Therapy of peri-implantitis: a systematic review. J Clin Periodontol 35(7):621–629

    Article  PubMed  Google Scholar 

  12. Esposito M, Grusovin MG, Kakisis I et al (2008) Interventions for replacing missing teeth: treatment of perimplantitis. Cochrane Database Syst Rev 16(2):CD004970

    Google Scholar 

  13. Moher D, Schulz KF, Altman D; CONSORT Group (Consolidated Standards of Reporting Trials) (2001) The CONSORT statement: revised recommendations for improving the quality of reports of parallel-group randomized trials. JAMA 285(15):1987–1991

    Article  PubMed  CAS  Google Scholar 

  14. ADA Council on Scientific Affairs. Dental mercury hygiene recommendations (2003). J Am Dent Assoc 134(11):1498–1499

    Google Scholar 

  15. American Dental Association Council on Scientific Affairs (2006) Professionally applied topical fluoride: evidence-based clinical recommendations. J Am Dent Assoc 137(8):1151–1159

    Google Scholar 

  16. De Boever JA, Nilner M, Orthlieb JD, Steenks MH (2008). Educational Committee of the European Academy of Craniomandibular Disorders. Recommendations by the EACD for examination, diagnosis, and management of patients with temporomandibular disorders and orofacial pain by the general dental practitioner. J Orofac Pain 22(3):268–278

    Google Scholar 

  17. Academy of Osseointegration; Committee for the Development of Dental Implant Guidelines; American Academy of Periodontology, Iacono VJ, Cochran SE, Eckert MR, Wheeler SL (2008) Guidelines for the provision of dental implants. Int J Oral Maxillofac Implants 23(3):471–473

    Google Scholar 

  18. Faggion CM Jr (2008) Clinician assessment of guidelines that support common dental procedures. J Evid Based Dent Pract 8(1):1–7

    Article  PubMed  Google Scholar 

  19. van der Sanden WJ, Mettes DG, Plasschaert AJ et al (2003) Clinical practice guidelines in dentistry: opinions of dental practitioners on their contribution to the quality of dental care. Qual Saf Health Care 12(2):107–111

    Article  PubMed  Google Scholar 

  20. Shekelle PG, Ortiz E, Rhodes S et al (2001) Validity of the Agency for Healthcare Research and Quality clinical practice guidelines: how quickly do guidelines become outdated? JAMA 286(12):1461–1467

    Article  PubMed  CAS  Google Scholar 

  21. Oxman AD, Schünemann HJ, Fretheim A (2006) Improving the use of research evidence in guideline development: 8. Synthesis and presentation of evidence. Health Res Policy Syst 4:20

    Article  PubMed  Google Scholar 

  22. Sterne JA, Egger M, Smith GD (2001) Systematic reviews in health care: investigating and dealing with publication and other biases in meta-analysis. BMJ 323(7304):101–105

    Article  PubMed  CAS  Google Scholar 

  23. Concato J, Shah N, Horwitz RI (2000) Randomized, controlled trials, observational studies, and the hierarchy of research designs. N Engl J Med 342(25):1887–1892

    Article  PubMed  CAS  Google Scholar 

  24. Atkins D, Best D, Briss PA et al (2004) Grading quality of evidence and strength of recommendations. BMJ 328(7454):1490

    Article  PubMed  Google Scholar 

  25. Hujoel PP, DeRouen TA (1995) A survey of endpoint characteristics in periodontal clinical trials published 1988-1992, and implications for future studies. J Clin Periodontol 22(5):397–407

    Article  PubMed  CAS  Google Scholar 

  26. Ebell MH, Siwek J, Weiss BD et al (2004) Strength of recommendation taxonomy (SORT): a patient-centered approach to grading evidence in the medical literature. J Am Board Fam Pract 17(1):59–67

    Article  PubMed  Google Scholar 

  27. Jaeschke R, Guyatt GH, Dellinger P et al (2008) Use of GRADE grid to reach decisions on clinical practice guidelines when consensus is elusive. BMJ 337:a744

    Article  PubMed  Google Scholar 

  28. Brazier J, Ratcliffe J, Salomon JA, Tsuchiya A (2007) Measuring and valuing health benefits for economic evaluation. Oxford University Press, Oxford

    Google Scholar 

  29. Drummond MF, Sculpher MJ, Torrance GW et al (2005) Methods for the economic evaluation of health care programmes. Oxford University Press, Oxford

    Google Scholar 

  30. Raikou M, McGuire A (2006) Estimating costs for economic evaluation. In: Jones AM (ed). The Elgar companion to health economics. Edward Elgar Publishing, Cheltenham (UK), Northampton (USA)

    Google Scholar 

  31. Pliskin J, Shepard D, Weinstein M (1980) Utility functions for life years and health status. Oper Res 28(1):206–224

    Article  Google Scholar 

  32. Birch S (1986) Measuring dental health: Improvements on the DMF-index. Community Dent Health 3:303–311

    PubMed  CAS  Google Scholar 

  33. Briggs A, Sculpher M (1998) An introduction to Markov modelling for economic evaluation. Pharmacoeconomics 13(4):397–409

    Article  PubMed  CAS  Google Scholar 

  34. Briggs A, Sculpher M, Claxton K (2006) Decision modelling for health economic evaluation. Oxford University Press, Oxford

    Google Scholar 

  35. Weinstein M (2006) Decision rules for incremental cost-effectiveness analysis. In: Jones AM (ed) The Elgar companion to health economics. Edward Elgar Publishing, Cheltenham (UK), Northampton (USA)

    Google Scholar 

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Correspondence to Clovis Mariano Faggion Jr. .

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Faggion, C.M., Listl, S.M., Schmitter, M. (2010). A Model for Implementing Evidence-Based Decisions in Dental Practice. In: Chiappelli, F. (eds) Evidence-Based Practice: Toward Optimizing Clinical Outcomes. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-05025-1_5

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  • DOI: https://doi.org/10.1007/978-3-642-05025-1_5

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  • Online ISBN: 978-3-642-05025-1

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