Evidence-based Dentistry, An Issue of Dental Clinics (The Clinics: Dentistry)

WHAT IS EVIDENCE BASED DENTISTRY?......Page 1
Was the Assignment of Patients to Treatment Randomized?......Page 2
Were Patients, Their Clinicians, and Study Personnel Blinded to Treatment?......Page 3
Were All Clinically Important Outcomes Considered?......Page 4
Will the Results help Clinicians in Caring for Their Patients?......Page 5
Will the Patient be Better Off as a Result of the Test?......Page 6
WHAT EVIDENCE BASED DENTISTRY IS NOT......Page 7
References......Page 8
HOW QUESTIONS ARISE......Page 10
WHICH QUESTIONS?......Page 11
For the Patient......Page 12
For the Searcher......Page 13
TYPES OF QUESTIONS......Page 14
Specific Definition of Search Terms......Page 15
Skimming Titles and Abstracts in Found Literature......Page 16
References......Page 17
Anecdote, Experience, or Evidence?......Page 19
SUMMARY......Page 25
References......Page 26
THE ETHICS OF EXPERIMENTING IN DENTAL PRACTICE......Page 27
GENERAL APPROACHES TO ETHICS......Page 28
A Discursive Approach to Ethics......Page 29
The Ethics Test......Page 31
Scientific Investigation......Page 33
Experimental Practice......Page 34
Patients’ Interests First......Page 35
Grounds for Expecting Success......Page 36
Systematic Approach......Page 37
READING THE LITERATURE......Page 38
Internal versus External Validity......Page 39
The Baseline Problem......Page 40
References......Page 41
CONDUCTING A SEARCH OF THE LITERATURE......Page 43
PEER-REVIEWED JOURNAL SOURCES......Page 44
ELECTRONIC DATABASES......Page 45
References......Page 47
TYPES OF RESEARCH STUDIES......Page 48
Descriptive Studies......Page 49
Analytic Studies......Page 50
MEASURES OF ASSOCIATION......Page 52
ASSESSING VALIDITY......Page 54
CRITERIA FOR CAUSALITY......Page 55
References......Page 56
BIAS IN DENTAL RESEARCH CAN LEAD TO INAPPROPRIATE TREATMENT SELECTION......Page 57
HIERARCHY OF RESEARCH DESIGN AND BIAS CONTROL......Page 58
Randomized, Controlled Trials: ‘‘Best at Bias Control’’......Page 59
Observational Comparison Studies: ‘‘Ranges of Bias Control’’......Page 61
Historical Control Groups......Page 64
Blind Participants......Page 66
Treat All Subjects the Same......Page 67
Calibration and Training of Examiners......Page 69
Accounting for all Subjects......Page 70
Data Used Appropriately: Chart Reviews and Errors of Omission......Page 71
References......Page 73
INTRODUCTION TO THE INFORMATION PROBLEM......Page 75
A SOLUTION FOR THE BUSY PRACTITIONER......Page 76
ANATOMY OF A SYSTEMATIC REVIEW......Page 77
WHAT TO LOOK FOR IN A USEFUL SYSTEMATIC REVIEW......Page 79
References......Page 81
THE USE OF DIAGNOSTIC DATA IN CLINICAL DENTAL PRACTICE......Page 83
THE DIAGNOSTIC PROCESS......Page 84
DIAGNOSTIC DECISION ANALYSIS......Page 85
Variation in the System or Phenomenon Being Measured......Page 88
Variability of Examiners......Page 89
Intraclass Correlation Coefficient......Page 91
MEASUREMENT VALIDITY AND THE REFERENCE STANDARD......Page 93
DIAGNOSTIC VALIDITY AND THE REFERENCE STANDARD......Page 94
TEST CHARACTERISTICS......Page 95
Post-test Likelihood of a Positive Test (PTL)......Page 96
Negative Predictive Value (NPV)......Page 97
High Threshold......Page 99
Receiver Operating Characteristic Analysis......Page 100
The Effects of Prevalence......Page 101
LIKELIHOOD RATIOS AND NOMOGRAMS......Page 105
References......Page 109
ASSESSMENT OF KEY ELEMENTS TO DETERMINE CAUSATION AND RISK FACTORS IN DENTISTRY......Page 112
RESEARCH STUDIES TO EVALUATE CAUSATION......Page 113
How is the Magnitude of a Risk Factor Reported?......Page 114
Prospective Cohort Studies......Page 115
Case-control Studies......Page 116
Randomized, Controlled Trials......Page 118
Bias in Research and Causation Studies......Page 119
SUMMARY......Page 120
References......Page 121
How to Use an Article about Prognosis......Page 122
CLINICAL SITUATION......Page 123
STUDY DESIGNS THAT YIELD INSIGHT AND IDENTIFY PROGNOSIS FACTORS......Page 124
Was Follow-up Sufficiently Long and Complete?......Page 126
How Large is the Likelihood of the Outcome Event  Over a Specified Period of Time?......Page 127
Are the Study Patients Similar to Those in the Practitioner’s Practice?......Page 129
References......Page 130
BIOSTATISTICAL CONSULTATION FOR DENTAL RESEARCH......Page 132
BASICS 1: HISTOGRAMS TO BELL-SHAPED CURVES......Page 133
BASICS 2: CONFIDENCE-INTERVAL ESTIMATES......Page 135
BASICS 3: COMPARING MEANS......Page 136
STATISTICAL NEEDS OF DENTAL PRACTITIONERS — GENERAL CONSIDERATIONS......Page 137
STATISTICAL TRAINING FOR DENTAL PRACTITIONERS......Page 138
STATISTICAL NEEDS OF DENTAL RESEARCHERS......Page 139
THE ROLE OF THE STATISTICAL CONSULTANT IN DENTAL RESEARCH......Page 140
COMPLICATING FACTORS......Page 141
SAMPLE SIZE AND POWER ANALYSIS......Page 143
SOURCES OF PILOT DATA......Page 144
DATA MANAGEMENT......Page 146
RESEARCH ADMINISTRATION......Page 147
DISCUSSION......Page 148
References......Page 149
GENERAL ISSUES......Page 151
SPECIFIC APPLICATIONS......Page 153
Diagnostic Tests......Page 154
Prognosis......Page 155
Therapy......Page 156
References......Page 157