How to Use Evidence-Based Dental Practices to Improve Clinical Decision-Making.
- 1st ed.
- 1 online resource (363 pages)
Intro -- Title -- Copyright -- Contents -- Preface -- How to Use This Book -- Chapter 1. Understanding and Applying the Principles of Evidence-Based Dentistry (EBD) -- Introduction -- Definition and Principles of EBD -- The Process of EBD -- Chapter 2. Searching for the Best Oral Health Evidence: Strategies, Tips, and Resources -- Introduction -- General Tips for Searching Electronic Resources -- Searching Workflow -- Resources -- Comprehensive Resources -- Epistemonikos -- Trip -- Summaries and Guidelines: Point-of-Care Resources -- UpToDate -- ClinicalKey -- Lexicomp -- ECRI Guidelines Trust -- ADA Center for Evidence-Based Dentistry -- Preappraised Resources -- Cochrane Library -- Journals -- Evidence-Based Dentistry (EBD) -- Journal of Evidence-Based Dental Practice (JEBDP) -- The Journal of the American Dental Association (JADA) -- Nonpreappraised Resources -- PubMed -- MEDLINE -- Embase -- Web of Science/Scopus -- Google and Google Scholar -- Citation Managers -- Gray Literature -- Patient Information Resources -- Conclusion -- Chapter 3. How to Appraise and Use an Article about Therapy -- Introduction -- Clinical Questions of Therapy -- What Study Design Best Addresses Questions of Therapy? -- Critically Appraising an RCT to Inform Clinical Decisions -- How Serious Is the Risk of Bias? -- Did the intervention and control groups start with the same prognosis? -- Was prognostic balance maintained as the study progressed? -- Were the groups prognostically balanced at the completion of the study? -- What Are the Results? -- How large was the treatment effect? -- How precise was the estimate of the treatment effect? -- How Can I Apply the Results to Patient Care? -- Were the study patients similar to my patients? -- Were all patient-important outcomes considered? -- Are the likely treatment benefits worth the potential harms and costs?. Conclusion -- Chapter 4. How to Use an Article about Harm -- Introduction -- Clinical Questions of Harm -- What Study Design Best Addresses Questions of Harm? -- Critically Appraising Observational Studies to Inform Clinical Decisions -- How Serious Is the Risk of Bias? -- Are exposed and unexposed study participants sufficiently similar? -- Is information collected in the same way in exposed and unexposed study participants? -- What Are the Results? -- How strong is the association between exposure and outcome? -- How precise was the estimate of the risk? -- How Can I Apply the Results to Patient Care? -- Were the study patients similar to the patients in my practice? -- Was the follow-up sufficiently long? -- Is the exposure similar to what might occur in my patient? -- Are there any benefits that offset the risks associated with the exposure? -- Conclusion -- Chapter 5. How to Appraise and Use an Article about Diagnosis -- Introduction -- Clinical Questions of Diagnosis -- What Study Design Best Addresses Questions About Diagnosis? -- Critically Appraising a Study Assessing the Properties of a Diagnostic Test to Inform Clinical Decisions -- How Serious Is the Risk of Bias? -- Did participating patients present a diagnostic dilemma? -- Did investigators compare the test with an appropriate, independent reference standard? -- Were the investigators who interpreted the test and reference standard blinded to the other results? -- Did investigators apply the same reference standard to all patients regardless of the results of the test under investigation? -- What Are the Results? -- How Can I Apply the Results to Patient Care? -- Will the reproducibility of the test results and its interpretation be satisfactory in my clinical setting? -- Are the study results applicable to the patients in my practice?. Will the test results change my management strategy? -- Will patients be better off as a result of the test? -- Conclusion -- Chapter 6. How to Use a Systematic Review and Meta-Analysis -- Introduction -- Knowledge Synthesis and Translation -- What Is the Difference Between Narrative and Systematic Reviews? -- Why Are Systematic Reviews Considered to Be a Study Design? -- Critically Appraising Systematic Reviews to Inform Clinical Decisions -- How Serious Is the Risk of Bias? -- Did the review present explicit and appropriate eligibility criteria? -- Was the search for relevant studies exhaustive? -- Did the primary studies have a low risk of bias? -- Were the selection and assessment of primary studies reproducible? -- What Are the Results? -- Were the results similar from study to study? -- What are the overall results of the review? -- Anatomy of a Meta-Analysis -- How precise were the results? -- What is the overall quality of the evidence (also known as confidence in the estimate of effect)? -- How Can I Apply the Results to Patient Care? -- Were all patient-important outcomes considered? -- Are the likely treatment benefits worth the potential harms and costs? -- Conclusion -- Chapter 7. How to Use Patient Management Recommendations from Clinical Practice Guidelines -- Introduction -- Evidence-Based Clinical Practice Guidelines -- Structured Process of Developing Management Recommendations -- Where to Find Clinical Practice Guidelines -- Critically Appraising Patient Management Recommendations -- Are the Recommendations Clear and Comprehensive? -- Is the recommended intervention clear and actionable? -- Is the alternative clear? -- Were all the relevant outcomes important to patients explicitly considered? -- Was the Recommendation Made on the Basis of the Best Current Evidence?. Are Values and Preferences Associated with the Outcomes Appropriately Specified? -- Do the Authors Indicate the Strength of Their Recommendations? -- Is the Evidence Supporting the Recommendation Easily Understood? -- For strong recommendations, is the strength appropriate? -- For weak recommendations, does the information provided facilitate shared decision-making? -- Was the Influence of Conflicts of Interest Minimized? -- Conclusion -- Chapter 8. How to Appraise an Article Based on a Qualitative Study -- Introduction -- When Is Qualitative Research Relevant? -- Where to Find Qualitative Studies -- Critically Appraising Qualitative Research to Inform Clinical Decisions -- Are the Results Credible? -- Was the Choice of Participants or Observations Explicit and Comprehensive? -- Was Research Ethics Approval Obtained? -- Was Data Collection Sufficiently Comprehensive and Detailed? -- Were the Data Analyzed Appropriately, and Were the Findings Corroborated Adequately? -- What Are the Results ? -- How Can I Apply the Results to Patient Care? -- Does the Study Offer Helpful Theory? -- Does the Study Help Me Understand the Context of My Practice? -- Does the Study Help Me Understand Social Interactions in Clinical Care? -- Conclusion -- Chapter 9. How to Appraise and Use an Article about Economic Analysis -- Introduction -- Why Economic Analysis in Dentistry? -- Cost-Effectiveness Analysis -- Cost-Utility Analysis -- Cost-Benefit Analysis -- Trial-Based versus Decision Model-Based Economic Analyses -- Critically Appraising an Economic Analysis to Inform Clinical Decisions -- How Serious Is the Risk of Bias? -- Are results reported separately for relevant patient subgroups? -- Were consequences and costs measured accurately? -- Did investigators consider the timing of costs and consequences? -- What Are the Results?. What were the incremental costs and effects of each strategy? -- Do incremental costs and effects differ between subgroups? -- How much does allowing for uncertainty change the results? -- How Can I Apply the Results to My Patient Care? -- Are the viewpoints and setting used in the study relevant to my context? -- Are the treatment benefits worth the risks and costs? -- Can I expect similar costs in my setting? -- Conclusion -- Chapter 10. How to Avoid Being Misled by Clinical Studies' Results in Dentistry -- Introduction -- Guidance on How to Avoid Being Misled by the Results of Clinical Studies -- 1. Read only the methods and results sections -- disregard the inferences -- 2. Read synoptic abstracts published in secondary publications (preappraised resources) for evidence-based dentistry -- 3. Beware of large treatment effects presented in trials with few events -- 4. Beware of statements of statistical significance that claim clinical significance -- 5. Beware of differences that are not statistically significant being interpreted as equivalence -- 6. Beware of uneven emphasis on benefits and harms -- 7. Beware of misleading subgroup analyses -- Conclusion -- Chapter 11. What Is the Difference between Clinical and Statistical Significance? -- Introduction -- Statistical Significance -- Type I Error -- Type II Error -- Study Power -- Issues Pertaining to Statistical Significance -- Clinical Significance -- Minimal Important Difference (MID) -- Patient-Reported Outcome Measures (PROMs) -- Surrogate Outcomes -- Interpreting Research Findings -- Confidence Intervals (CIs) -- CIs and MID -- Discussion -- Conclusion -- Chapter 12. A Primer to Biostatistics for Busy Clinicians -- Introduction -- Research Design and Clinical Interpretation -- Experimental Trial -- Observational Studies -- Measures of Association -- Mean Difference. Standard Mean Difference.
This book is a one-stop resource for learning how to harness the power of the latest scientific information and optimize patient care. How to Use Evidence-Based Dental Practices to Improve Your Clinical Decision-Making is the definitive resource for dental students and practitioners who want to learn from leaders in the field of evidence-based dentistry (EBD); quickly conduct searches for the latest research; master the skill of critically appraising clinical studies; confidently apply the latest research to patient care; teach others how to inform their practice with the latest clinical evidence; and access everything they need to become an EBD all-star. The ADA Center for Evidence-Based Dentistry oversaw the development of this publication. Dental teams and educators alike will find it a useful resource for incorporating the most up-to-date scientific evidence in clinical decisions and instilling others with the curious mindset needed to provide evidence-based health care. Includes link to e-book.