Evidence Based Dentistry Resources

Evidence Based Dentistry

Resources
Prof. Pedro

A. Del Valle López, MLS
pedro.delvallelopez@upr.edu
Bibliotecario Enlace
Escuela de Medicina Dental

ADA Policy on Evidence-Based Dentistry
ADA defines the term “evidence-based dentistry” as

follows:

“Evidence-based dentistry is an approach to oral health care that
requires the judicious integration of systematic assessments of
clinically relevant scientific evidence, relating to the patient's oral
and medical condition and history, with the dentist's clinical
expertise and the patient's treatment needs and preferences.”
(Trans. 2001:462).
Available at: http://www.ada.org/1754.aspx.

ADA Policy on Evidence-Based Dentistry
“In adopting this definition for EBD, the ADA recognizes that

treatment recommendations should be determined for each
patient by his or her dentist, and that patient preferences should
be considered in all decisions. Dentist experience and other
circumstances, such as patients’ characteristics, should also be
considered in treatment planning. EBD does not provide a
“cookbook” that dentists must follow, nor does it establish a
standard of care. The EBD process must not be used to interfere
in the dentist/patient relationship, nor is it to be used as a costcontainment tool by third-party payers.”

Available at: http://www.ada.org/1754.aspx.

Where to Look for Evidence
Based Dentistry Resources?

The Cochrane Handbook for
Systematic Reviews of Interventions
The Cochrane Handbook for Systematic Reviews of

Interventions is the official document that describes
in detail the process of preparing and maintaining
Cochrane systematic reviews on the effects of
healthcare interventions. The current version of the
Handbook is 5.1.0

The Cochrane Handbook for Systematic Reviews of Interventions (2011). Julian PT Higgins and Sally
Green, Eds. The Cochrane Collaboration. Last modified on March 2011. accessed on: September
12th, 2013. Available online at: http://handbook.cochrane.org/.

The Cochrane Handbook for
Systematic Reviews of Interventions
Also available in spanish: Manual Cochrane de

revisiones sistemáticas de intervenciones (PDF only)

URL:
http://www.cochrane.es/files/handbookcast/Manual_Cochrane

The Cochrane Handbook for Systematic Reviews of Interventions (2011). Julian PT Higgins and Sally
Green, Eds. The Cochrane Collaboration. Last modified on March 2011. accessed on: September
12th, 2013. Available online at: http://handbook.cochrane.org/.

The Cochrane Handbook for Systematic Reviews
of Diagnostic Test Accuracy
“This is the webpage for three related entities of the

Cochrane Collaboration; the Diagnostic Test Accuracy
Working Group, the Regional Support Units and the
Diagnostic Test Accuracy Editorial Team. The combined
roles of these entities is to implement the Cochrane
Steering Group's decision to publish systematic reviews of
diagnostic test accuracy in The Cochrane Library”.

The Cochrane Handbook for Systematic Reviews of Diagnostic Test Accuracy. (2011). Diagnostic Test
Accuracy Working Group. Last modified on Friday, September 13th, 2013. accessed on: September
17th, 2013. Available online at: http://srdta.cochrane.org/handbook-dta-reviews.

Textbooks
The BAD side:
Are out of date when published.
“[I]nclude[s] 'established knowledge' that doesn't
change (much) such as anatomy, physical properties of
dental materials, drug adverse effects”.
The GOOD side:
Most of the time, provide useful summaries.
Evidence Based Dentistry (2013). University Library. The University of Adelaide. Last modified on
September 16, 2013 . Available at: http://www.adelaide.edu.au/library/guide/med/tut/dent/ebd1.html.

Journals
High impact general journals
These are useful for keeping up to date with the
broad discipline:
 Nature
 Lancet
 Journal of Dental Research


Journals
Specialist journals
These provide information on professional news,
government policy, research and practice trends:
 Angle Orthodontist
 Community Dentistry and Oral Epidemiology
 Journal of Periodontology
 Journal of Prosthetic Dentistry
 Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology

and Endodontology


Journals
There are now more journals that
are specifically aimed at evidence
based dentistry practice.


Article types useful for EBD (1)
Laboratory experiments
While test tube experiments are essential in all areas of

medicine including dentistry, clinicians can't base treatment
on the results.

Animal experiments
Some useful results have come from animal experiments,

and while these may indicate the usefulness of human trials,
clinicians can't use these articles.

Case reports
These are often memorable and can serve as a reminder

for diagnosis and treatment, but you can't base a practice on
small populations (1 patient) where bias may be present.


Phase I trials
Usually conducted on small numbers of healthy volunteers to

look for adverse effects. These results aren't appropriate for
clinicians working with patients.

Phase II trials (Case Series)
Mostly these use small numbers of selected patients, or a series

of patients often without a control group to test the outcome of
an intervention. Results of Phase II Trials are not usually
considered sufficiently objective and rigorous enough to use in
clinical decisions.


Phase III trials
Large long term trials on patients, usually with randomized

control, double or single blinding, control groups, placebos etc.
These trials can be used to make clinical decisions.

Phase IV trials
These are usually post marketing trials on very large numbers of

patients to gauge the long term safety and find rare adverse effects
of interventions. Useful for clinical decision making.


Systematic Reviews
These are peer reviewed articles that bring together all the

objective studies on interventions for particular conditions.
Sometimes authors do this to compare interventions, and
sometimes to join study results to increase the size of the
population tested. If the original articles are not randomized
controlled trials, then the authors should explain why they are
used in the analysis and what adjustments were made in the
statistical analysis to include them. These are useful for clinical
decisions, often called the gold standard.


Cohort Studies
Patients with a particular condition are followed over time and

compared with a control group. Cohort studies aren't as reliable as
controlled trials but are useful in situations where it wouldn't be ethical
to run a randomised trial. Types of cohort studies include:
 Longitudinal Studies where particular groups or individuals within a

cohort are studied.
 Follow-up Studies study the effect of exposures, procedures, or
characteristics such as a disease.
 Prospective Studies study the incidence or mortality in subgroups after
their selection.

Cohort studies can be used for making clinical decisions.

Clinical Practice Guidelines
Should be evidence based serial statements to assist in diagnosis

and treatment of particular conditions. Care should be taken to
ensure that these are NOT based only on expert opinion. Look
carefully at the evidence summary to ensure that the evidence is
both comprehensive and up to date. You'll also need to see if it's
possible to follow through with the guideline in your situation.


Evidence-Based Dentistry (Nature Publishing Group)
ISSN: 1462-0049
eISSN: 1476-5446
From 1998 to present
Publisher:
British Dental Association

Editor:
Derek Richards

Journal of Evidence Based Dental Practice (Elsevier)
ISSN: 1532-3382
eISSN: 1532-3390
From 2001 to present
Publisher:
MOSBY – An Elsevier Imprint

Editor:
Michael G. Newman

Bandolier Journal (Bandolier Team)
ISSN: N/A
eISSN: N/A
From February 1994 to July 2007
Publisher:
Bandolier Team

Editor:
Bandolier Team

Bandolier Journal Updates (Bandolier
Team)

ISSN: N/A
eISSN: N/A
From February 1994 to July 2007
Publisher:
Bandolier Team

Editor:
Bandolier Team

Bandolier Extra (Bandolier Team)

PubMed Clinical Querries
“Results of searches on this page are

limited to specific clinical research areas.
For comprehensive searches, use PubMed
directly”.

PubMed Help. Accessed on September 12th, 2013. Last Update June 25, 2013.
Available at: http://www.ncbi.nlm.nih.gov/books/NBK3827/#pubmedhelp.Clinical_Queries_Filters

Clinical Queries using Research Methodology Filters


Systematic Reviews Search Filter

Search Strategy Used to Create the Systematic Reviews Subset on PubMed. Accessed on September 12th, 2013.
Last Update February, 2013. Available at:
http://www.ncbi.nlm.nih.gov/books/NBK3827/#pubmedhelp.Clinical_Queries_Filters

Medical Genetics Search Filters


PubMed Health (1)
“PubMed Health provides information for consumers and

clinicians on prevention and treatment of diseases and
conditions”.

“PubMed Health specializes in reviews of clinical

effectiveness research, with easy-to-read summaries for
consumers as well as full technical reports. Clinical
effectiveness research finds answers to the question ‘What
works?’ in medical and health care.”

PubMed Health. Accessed on September 12th, 2013. Last Update June 25, 2013.

PubMed Health (2)
“PubMed Health is based on systematic reviews of clinical

trials. These clinical effectiveness reviews can show what
treatments and prevention methods have been proven to
work—and what remains unknown”.

“PubMed Health provides summaries and full texts of

selected systematic reviews in one place. The reviews were
generally published or updated from 2003. There is also
information for consumers and clinicians based on those
reviews”.


PubMed Health (3)
A search on PubMed Health runs simultaneously in

PubMed.

A filter is used to identify all the indexed scientific articles

at the NLM that might be systematic reviews.

This search includes articles from before 2003.


PubMed Health (4)
Information partners selected by PubMed Health to

contribute their clinical effectiveness information are:










Agency for Health Care Research and Quality (US) (AHRQ)
Centre for Reviews and Dissemination (CRD)
The Cochrane Collaboration (CC)
German Institute for Quality and Efficiency in Health Care (IQWiG)
National Cancer Institute (NCI)
National Institute for Health and Care Excellence guidelines program (NICE)
National Institute for Health Research (NIHR) Health Technology Assessment Programme
(NIHR HTA)
Oregon Health and Science University's Drug Effectiveness Review Project (DERP)
Department of Veterans Affairs' Evidence-based Synthesis Program from the Veterans Health
Administration R&D (VA ESP)


Guidelines and Evidence Sources

Guidelines and Evidence Sources
“Includes links to systematic reviews and lists
of reviews in process, protocols etc.”


Feature

Narrative review

Systematic Review

Question

Broad Scope

Focussed

Sources & Search

Not usually specified

Appraisal

Variable

Comprehensive &
explicit
Rigorous

Synthesis

Often qualitative
summary
Sometimes evidencebased

Inferences

Quantitative summary
Usually evidencebased

Guidance
•PRISMA - (Preferred Reporting Items for Systematic Reviews and MetaAnalyses) the PRISMA Statement is an update and expansion of the now-out dated
QUOROM Statement.
•MOOSE - a proposal for reporting meta-analysis of observational studies in
epidemiology
•QUADAS - quality assessment tool for use in systematic reviews of diagnostic
accuracy studies
•Cochrane Reviewers’ Handbook
•Cochrane review production resources
•Undertaking Systematic Reviews of Research on Effectiveness - CRD Report
Number 4. 2nd Edition
•Systematic Reviews: CRD’s guidance for undertaking reviews in health care -Mar09
•PROSPERO - prospective register of systematic reviews

 Trip is a clinical search engine designed to allow users to quickly

and easily find and use high-quality research evidence to support
their practice and/or care.
 Trip has been online since 1997 and in that time has developed

into the internet’s premier source of evidence-based content.
Our motto is ‘Find evidence fast’ and this is something we aim to
deliver for every single search.
 As well as research evidence we also allow clinicians to search

across other content types including images, videos, patient
information leaflets, educational courses and news.

http://pesquisa.bvsalud.org/evidences/?
where=GROUP_REVIEWS&lang=es

GRAY LITERATURE:
THESES AND DISSERTATIONS

Evidence Based Dentistry Resources

Evidence Based Dentistry Resources

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