Evidence-based dentistry: a model for clinical practice.
Making decisions in dentistry should be based on the best evidence available. The objective of this study was to demonstrate a practical procedure and model that clinicians can use to apply the results of well-conducted studies to patient care by critically appraising the evidence with checklists and letter grade scales. To demonstrate application of this model for critically appraising the quality of research evidence, a hypothetical case involving an adult male with chronic periodontitis is used as an example. To determine the best clinical approach for this patient, a four-step, evidence-based model is demonstrated, consisting of the following: definition of a research question using the PICO format, search and selection of relevant literature, critical appraisal of identified research reports using checklists, and the application of evidence. In this model, the quality of research evidence was assessed quantitatively based on different levels of quality that are assigned letter grades of A, B, and C by evaluating the studies against the QUOROM (Quality of Reporting Meta-Analyses) and CONSORT (Consolidated Standards of Reporting Trials) checklists in a tabular format. For this hypothetical periodontics case, application of the model identified the best available evidence for clinical decision making, i.e., one randomized controlled trial and one systematic review of randomized controlled trials. Both studies showed similar answers for the research question. The use of a letter grade scale allowed an objective analysis of the quality of evidence. A checklist-driven model that assesses and applies evidence to dental practice may substantially improve dentists' decision making skill.
Faggion
Clóvis M
CM
Leeds Dental Institute and Biostatistics Unit, Centre for Epidemiology and Biostatistics, University of Leeds. clovisfaggion@yahoo.com
Tu
Yu-Kang
YK
D003657:Decision Making; D018865:Dental Research / Q000592:standards; D004497:Education, Dental / Q000379:methods*; D019317:Evidence-Based Medicine; D006801:Humans; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D010517:Periodontics / Q000193:education* / Q000592:standards; D010518:Periodontitis / Q000628:therapy; D016032:Randomized Controlled Trials as Topic; D012196:Review Literature as Topic