Dentistry

Image from: The Journal of the American Dental Association Volume 145 Issue 12 Pages 1262-1267 (December 2014). DOI: 10.14219/jada.2014.113

Evidence-based dentistry is the combination of the best scientific information available, the Dentists expertise and the patients preferences and needs for optimal oral health. Successful evidence-based practice is reliant on finding the reliable and up-to-date information, studies and literature. There are several indicators that you can you to make evidence-based decisions.

• Evidence Based Pyramid
• Types of Studies
• Crafting Researchable Questions (PICO)
• Conducting Literature Searches 

Primary Literature (Unfiltered Literature)

Case Series/Case Reports - reports on the treatment of one or more individual patients. There are no control groups to compare outcomes.  This type of research has little statistical validity.

Case Control Series - patients who already have a specific condition are compared with people who do not have the condition, looking back in time to identify factors that might be associated with the illness.  Case control studies often rely on medical records & patient recall for data collection, so their reliability is limited.

Cohort Studies -  compare a group of patients who are already under a specific treatment with a similar group not affected by the treatment. Both groups are followed over time. Cohort studies are observational, so their reliability is limited.

Randomized Controlled Studies - carefully planned experiments that look at the effects of a treatment on real patients in real time. To reduce the potential for bias, randomization & blinding are used in the selection of patients & treatments.  Patients are assigned to treatment & control groups randomly; patients & clinicians (& sometimes laboratories) do not know who is in which group & thus who is receiving treatment or not.  This allows the groups to be directly compared. RCTs can provide sound evidence of cause & effect & are considered the gold standard for experimental research.

Secondary Literature ( Filtered Literature)

Systematic Reviews - answer a specific question, using the results of an extensive literature search that identifies studies with sound & similar methodologies. The studies are reviewed, assessed for quality, & the results are summarized according to the standards of the question that is being reviewed.

Scoping Reviews - systematically maps the breadth of knowledge on a specific topic to identify key concepts, identify gaps and clarify definitions. Scoping reviews can occur prior to a systematic review. However, they may not answer a researchable question, but have broader inclusion criteria.  

Meta Analysis - thoroughly examine a number of valid studies on a topic & mathematically combine the results using statistical methodology to report the results of the analysis as if it were one large study. Requires a systematic review to choose included and excluded studies.

Question: In the pediatric population, do children with fluoride in their water have less cavities then children without fluoride in their water over a 2 year time period?

Image below: image from https://musc.libguides.com/ebd/PICOTT#loaded

Conducting Literature Reviews

Formulation and running your search takes careful consideration when determining your search strategy, choosing databases, adapting your search and organizing your results.to perform the best analysis. The NEOMED Librarians are here to assist you through this process. You can access and view tutorials here.

We are happy to set up appointment to discuss and work with you on your literature searches. Make an appointment with us and we'll get working on your project!