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How do we know what to believe?
An introduction to evidence-based dentistry.
Dr. Richard Niederman
More than 500 new human clinical trials confront clinicians each year. Deciding which to believe and which to ignore is a significant challenge.
Here we provide a 3-step method to quickly cull the wheat from the chaff. The 3-steps are:
- Asking a focused question,
- Searching for the best evidence,
- Critically appraising the evidence.
This seminar will walk participants through the 3-step method. It will demonstrate how, with practice, this process can be accomplished in less than 5 minutes.
We will use as an example fluoride varnish in caries prevention as a case study.
New products and methods range from diagnostics, to preventive measures, to treatment materials and methods. The methods can be applied to all of these topics, as well as personal clinical issues and questions.
Participants will learn:
- How to ask answerable questions,
- How to rapidly (<5 minutes) find the best evidence,
- How to extrapolate from case studies using fluoride and caries to personal clinical issues and questions.
Presenter Disclosure: Dr. Richard Niederman received an honorarium from Colgate-Palmolive to compensate for the time involved preparing and giving this presentation.
Target audience: Dentists, Hygienists and Assistants.
Release date: Wednesday, December 07, 2011
Expiration date: Sunday, December 07, 2014
"How do we know what to believe?" is co-sponsored by Dental Tribune America, LLC. Dental Tribune America LLC is a recognized ADA CERP provider.
The speaker will answer your questions
2) Even when you find high-level science that goes to your clinical question, you must remember that such studies compare average outcomes. While averages are useful, remember that no patient is "average" in every way.
3) You can subscribe to the two EB journals in dentistry, namely the Journal of Evidence Based Dentistry and the Journal of Evidence Based Dental Practice where "experts" review what's been in the literature and can give you insights into how good the science is. Unfortunately, neither of these resources is infallible.
4) One can dutifully dig thru the Cochrane Reviews, now available to you on-line as part of your ADA membership. Cochrane Reviews are the gold standard, but not every review is perfect.
5) One can tune-into the ADA's Evidence-based Center for tips and reviews of systematic reviews -- the most thoughtful opinions I've seen anywhere.
Bottom line is that evidence exists to lead us to the truth. Yet, evidence may be incomplete (often is), inappropriate, out-of-date or otherwise limited in its applicability to the clinical question we seek answered. Nevertheless, EB efforts are usually better than just guessing or relying on what one learned in dental school or residency and perhaps better than the latest "nugget" from an über-hyped CE speaker. The fact that there are unlimited permutations regarding how existing evidence applies to each and every patient at each and every time in his life, is why the ADA's definition of EB dentistry goes along the lines of the "judicious use" of the "best available evidence" in the context of a patient's needs and desires and the practitioner's skill and judgment.
IOW, EB dentistry is one more step along a continuum seeking clinical excellence.
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Dr. Richard Niederman is a Senior Member of the Staff at The Forsyth Institute and Director, Forsyth Center for Evidence-Based Dentistry.
He graduated magna cum laude in 1976 from the Harvard School of Dental Medicine where he also received his periodontal specialty training. He received certificate training in Evidence-Based Medicine at Oxford University in 1996.
He is the founding USA editor of the journal Evidence-Based Dentistry; the founding editor for the Global Centers for Evidence based dentistry, its website and search engine www.EviDentista.org and its search engine www.EviDents.org . He is the co-author of the book Evidence-based Dentistry: Managing Information for Better Practice, and has published more than 100 articles evidence-based articles ranging from molecular biology to practice implementation trials and editorials, and provided training in evidence-based dentistry on 5 continents over the last 10 years. His current work is implementing evidence-based caries prevention programs in at-risk communities in the U.S. and Latin America.