Oral_Biology_Evidence_Based_Dentistry_Assignment.pptx

Evidence_Based_Dentistry_Assignment

1. Evidence-Based Dentistry: Critical Appraisal & Research Design Master's Student in Oral Biology October 2024

2. Table of Contents 1. Stages of Evidence-Based Dentistry 1.1 Ask the Question 1.2 Acquire the Evidence 1.3 Appraise the Evidence 1.4 Apply the Evidence 1.5 Assess the Outcome 2. Advantages & Limitations of Critical Appraisal 2.1 Strengths of Critical Appraisal 2.2 Limitations of Critical Appraisal 3. Critical Appraisal Tools 3.1 CASP (Critical Appraisal Skills Programme) 3.2 AMSTAR (A Measurement Tool to Assess Systematic Reviews) 3.3 PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 4. Research Idea & Questions 4.1 Identifying a Research Gap in Oral Biology 4.2 Formulating Research Questions

3. Stages of Evidence-Based Dentistry Evidence-based dentistry (EBD) is an approach to oral healthcare that integrates the best available evidence with clinical expertise and patient values. The process of practicing EBD involves several critical stages designed to ensure that the decisions made are based on rigorous scientific research and applicable to the patient's needs. The stages of EBD are broken down into five key steps: Ask, Acquire, Appraise, Apply, and Assess. These stages ensure that dental practitioners consistently utilize high-quality evidence in their clinical decision-making process. 1. **Ask the Question**: The foundation of evidence-based dentistry begins with identifying a clear clinical question. This typically follows the PICO format (Patient problem, Intervention, Comparison, and Outcome), ensuring that the question is specific and researchable. For example, a question might ask whether a particular fluoride treatment is more effective in reducing cavities in pediatric patients compared to another treatment. This stage is crucial as it narrows down the focus and drives the direction of the research. 2. **Acquire the Evidence**: Once the question is clearly defined, the next step is to gather the most relevant and high-quality evidence. This often involves conducting a comprehensive search of scientific databases such as PubMed, Cochrane, and Google Scholar. The goal is to acquire a wide range of studies, including randomized controlled trials, systematic reviews, and meta-analyses, which are considered to be at the top of the evidence hierarchy. Proper search strategies, including the use of specific keywords and filters, are essential for obtaining the best evidence. 3. **Appraise the Evidence**: Not all evidence is created equal, and the quality of the studies must be critically appraised. This is where the clinician evaluates the validity, impact, and applicability of the research findings. Factors such as study design, sample size, biases, and statistical significance are taken into account. Appraisal tools, such as the Critical Appraisal Skills Programme (CASP) or AMSTAR, are commonly used at this stage. This process helps to weed out studies with flawed methodologies or biased results, ensuring only the most credible evidence is considered. 4. **Apply the Evidence**: After appraising the evidence, the next step is to apply the findings in a clinical setting. This requires integrating the best available evidence with the clinician's expertise and the patient's preferences. For example, even if a particular treatment shows strong evidence for effectiveness, it might not be suitable for a patient due to their medical history, age, or personal preferences. Hence, shared decision-making is key to the application of evidence-based dentistry. 5. **Assess the Outcome**: The final step in the EBD process is evaluating the effectiveness of the treatment or intervention. This involves follow-up assessments to determine if the patient’s health outcomes have improved as expected. If the results are unsatisfactory, the clinician may need to revisit earlier stages to modify the treatment plan or explore alternative evidence. Continuous assessment ensures that EBD is a dynamic process, allowing for adjustments based on patient responses and new evidence.