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DOH115 Research Skills Guide: Evidence-Based Dentistry

Introduction

When searching for information in the field of dentistry to answer clinical or research questions, you may be required to locate evidence-based practice resources. The information below and on the following page provide an introduction to the Evidence Based Practice concept.

What is Evidence-Based Practice?

Evidence Based Practice was first defined by Dr David Sackett in the 1990s, but a more recent definition has it as

“integrating the best available research evidence with clinical expertise and the patient’s unique values and circumstances” (Straus, Glasziou, Richardson, & Haynes, 2011).

And "it also requires the health professional to take into account characteristics of the practice context in which they work" (Hoffman, Bennett, & Mar, 2016, p. 4).

  • Evidence-based practice is the intersection of clinical expertise, research evidence, information from the practice context, and the patients values and circumstancesThe best research evidence is usually from relevant research that has been carried out using sound methodology.
  • Clinical expertise is a combination of the clinician’s experience, education and clinical skills.
  • The patient has his/her own personal preferences, concerns, expectations, and values.
  • The practice context includes characteristics of the situation in which the interaction between patient and health professional is taking place - for example, the resources available.

 

 

Evidence-Based Practice has been expanded from Evidence-Based Medicine to apply to other health professions including Dentistry. 


The Clinical Question - PICO

As noted above, the first step in the evidence-based practice process is to formulate a clinical question.

The clinical question should be relevant to the patient or the problem and formulated in such a way as to help with the search for an answer.   

PICO makes this process easier ...

The PICO concept is commonly used to formulate the clinical question. Each of the 4 letters identifies a key concept that needs to be in research articles that will answer the question:

                            Patient / Population / Problem Start with the patient, or group of patients, or problem
I Intervention What is the proposed intervention?
C Comparison

What is the main alternative, to compare with the intervention?

O

Outcome What is the anticipated or hoped-for outcome?

PICO is commonly used when one intervention is being compared with another, or with no intervention at all.

For more information on PICO & formulating a clinical question please see: Evidence-Based Practice: PICO and SPIDER

The Steps in EBP

There are various ways of listing the steps in the Evidence-Based Practice process, but a common way has 5 main steps:

1 Expressing the problem as a clinical question (Ask the question)
2 Finding evidence-based resources that answer the question (Acquire the evidence)
3 Critically appraising the evidence to assess its validity (Appraise the evidence)
4 Applying the evidence (Apply the evidence)
5 Re-evaluating the evidence and its application (Re-evaluate the evidence)

More Resources

Evidence Based Practice Library resource guide created by the Charles Sturt University Library:

Tutorials

From a tutorial compiled by the Duke University Medical Center Library and the Health Sciences Library at the University of Carolina at Chapel Hill.

Websites

Further Reading