EBD PRECONFERENCE SESSION: EVIDENCE FINDING SEARCH STRATEGIES. Jane Gillette, DDS Julie Frantsve-Hawley, RDH, PhD
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1 EBD PRECONFERENCE SESSION: EVIDENCE FINDING SEARCH STRATEGIES Jane Gillette, DDS Julie Frantsve-Hawley, RDH, PhD
2 Welcome!! Agenda: Overview of evidence finding search strategies and critical appraisal Technique #1: finding evidence that focuses on pre-appraised evidence and high quality systematic reviews (SR) Technique #2: finding evidence with PubMed that focuses on SR, metaanalysis and practice guidelines Hands-on EBD search Q & A
3 Evidence finding Search Strategies
4
5
6 TECHNIQUE #1 UTILIZING PRE-APPRAISED EVIDENCE AND HIGH QUALITY SYSTEMATIC REVIEWS (SR) Jane Gillette, DDS
7 Not all evidence is created equal (even SR) Even SR can be of poor quality (Major 2006, Glenny 2003) 81% did not identify all relevant studies 20% used Medline only Bias! 20% contained no documentation of the search strategies employed 75% used only 1 reviewer to select studies 61% limited language
8 Critical appraisal Is essential for all evidence Evaluates the strength, content and quality of a SR Can be simple What are the results? Are the results valid? Randomization, controls, evaluation of bias of the included studies Will the results help me in caring for my patients? Can be very complex AMSTAR guidelines A critical summary is the product of the critical appraisal process
9 Resources Critical summaries: EBD.ADA.org (critical summaries of SR) DARE Abstracts (critical summaries of SR & economic evaluations of original research) Bandolier (critical summaries of SR) The Journal of Evidence-based Dental Practice (critical summaries of original research) Evidence-based Dentistry (critical summaries of original research) High quality SR: The Cochrane Collaboration = gold standard of SR May choose to skip critical appraisal process if found
10 Benefits of utilizing pre-appraised evidence and high quality SRs Fast, simple, efficient combines the search and appraisal processes May thoroughly answer your question Demands a minimal amount of skill Utilizes appraisals completed by experts Opportunity to learn critical appraisal techniques Cost: minimal or often free
11 Will orthodontic treatment improve symptoms of TMD?
12 EBD.ADA.org
13 EBD.ADA.org
14 EBD.ADA.org
15 EBD.ADA.org
16 EBD.ADA.org TMD & Occlusion Part 1: Damned if we do? Occlusion the Interface of Dentistry and Orthodontics
17 PubMed
18 Full text at British Dental Journal It was not possible to carry out a systematic review
19 Full text at British Dental Journal Orthodontic treatment neither causes nor cures TMD.
20 EBD.ADA.org TMD in relation to malocclusio n and orthodontic treatment
21 EBD.ADA.org Insufficient vs. weak
22 EBD.ADA.org This review provides no support for an association between malocclusion and TMD. Similarly, High quality SR there is no evidence that orthodontic treatment may cause TMD.
23 EBD.ADA.org
24 PubMed
25 Original SR
26 EBD.ADA.org Orthodont ics and TMD: a meta analysis
27 PubMed
28 Centre for Reviews and Dissemination
29
30
31 DARE Abstracts Studies of orthodontic treatment to treat TMD were excluded.
32 DARE Abstracts
33 DARE Abstracts There are insufficient research data on which to base our clinical practice on the relationship of active orthodontic intervention and TMD. Cochrane Review!!! There is an urgent need for high quality randomized controlled trials in this area of orthodontic practice.
34 The Journal of Evidence-based Dental Practice
35 The Journal of Evidence-based Dental Practice
36 The Journal of Evidence-based Dental Practice Cool article.. but didn t really answer my question.
37 So what did I find? British Dental Journal EBD.ADA DARE X but not really a SR & didn t answer my question SR Critical Appraisal of SR Other X good quality SR & ANWERED MY QUESTION!!! X good quality SR, but did not answer my question JEBDP Cochrane X good quality SR & ANWERED MY QUESTION!!! X- interesting article, but did not answer my question
38 How will this impact my patient care? There is insufficient evidence to support orthodontics as a treatment for TMD. I will not recommend orthodontics as a treatment for TMD for my patient at this time. I will continue to check my resources periodically for updated evidence.
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