8. Evidence Based Dentistry II Flashcards
(38 cards)
Justifying the decisions we make ● Asking \_\_\_\_ ● Asking peers ● Telling \_\_\_\_ ● Panels of experts ● Looking at \_\_\_\_ ● Paying attention to what’s happened recently ● Narrowing our \_\_\_\_ ● Going to youtube ● Doing what we think “\_\_\_\_” is doing ● Going with our “gut”
mentors stories textbooks focus everyone else
Why we need EBD ● Constant new \_\_\_\_ ● Constant new techniques ● Need to \_\_\_\_ our decisions to insurance companies and our patients ● Eliminate overuse underuse misuse ● Triple aim ○ Improve \_\_\_\_ of care ○ Improve \_\_\_\_ of care ○ Decrease \_\_\_\_ of care
products defend quality standard cost
Limitations and Criticisms of EBD ● Limitations ○ Some things are not studied for the \_\_\_\_ reasons ○ Some things have \_\_\_\_ quality evidence ○ Sometimes there is too much \_\_\_\_
● Criticisms
○ “____” medicine
○ About younger clinicians vs. older clinicians
○ Really about ____ and being told “what to do”
• Some things are not studied because it seems \_\_\_\_
wrong
poor
information
cook book
surveillance
obvious
Formulating PICO questions P: \_\_\_\_ problem or population I: \_\_\_\_ C: \_\_\_\_ O: \_\_\_\_
patient
intervention
comparison
outcomes
How to search for evidence
____
____
____
ADA library
cochrane
pubmed
SORT Criteria
A: ____ and good quality ____ oriented evidence
B: ____ or limited quality ____ oriented evidence
C: Recommendation based on ____, usual practice, opinion, disease- oriented evidence and case series
consistent patient inconsistent patient consensus
Validity, reliability, and generalizing
● Validity - Whether the questions asked by the study are answered by the method
○ Requires that the test is highly ____, specific, and ____
● Reliability - the ____ and ____ of a test
● Generalizability - the ability to make ____ about a larger group or a
different group, based on the sample
sensitive unbiased repeatbility reproducibility assumptions
Types of scientific articles Human subjects research: Case \_\_\_\_ Case \_\_\_\_ \_\_\_\_ study \_\_\_\_ study \_\_\_\_ control study
“Bench” science
report series cohort case-control randomized
Sampling strategies Drawing conclusions about an entire population based on a sample from that population ● \_\_\_\_ of sample ○ Expense,time,practicality ● \_\_\_\_ of sample ○ Random sample ○ Convenience sample ○ Snowball sample
size
type
Avoiding bias
● ____
○ a study in which all subjects have an equal chance of being assigned
to either the study or control group
○ a sample in which individuals are selected randomly from the
population
● ____
○ When subjects are unaware of whether they are in a test or control group. Often necessitates use of placebos.
○ When neither participants or examiners are aware of what the groups are → “____”
randomization
blinding
double blind
X and Y
Independent variable - variable whose value ____ that of others. Most often “____”
Dependent variable - variable whose value ____ on those of others. Most often “____”
Assignment of these variables is ____ and based on the ____ design.
determines x depends y subjective study
Case-Control: Literacy/Missed appts
Take a look!
Ya!
Effect Modification
• \_\_\_\_ variable that has an effect on X, Y
third
Missed appointments
Patient or diseased centered outcome?
Disease-centered`
Basic terminology
Frequency
The ____ of disease in a population.
A number with no ____.
• No denominator - do not know \_\_\_\_ of problem
distribution
denominator
magnitude
Frequency
For some purposes, ____ is enough.
If I have 5 sets of sealant materials and 5 children who need sealants, I have enough material.
frequency
Prevalence
When frequency is not enough.
Prevalence = ____/ ____
• Population is \_\_\_\_, out of 100 children this day, etc, a moment of time
frequency
population
arbitrary
Incidence vs Prevalence: Caries
____ = decayed, missing and filled teeth
Prevalence of sever caries is going down
Go from passive to ____ consent (parents are more wiling to participated)
DMFT
explicit
Prevalence example: Access to care
* Just becoasue offices exist, doesn’t mean it's \_\_\_\_ patients * Says there are enough patients to treat low income folks - but dentists don't take all of these patients - saying there's no need to expand care, but this is not the case
accepting
Incidence
How are things changing over time?
Number of ____ vs. Number of ____
… smokers (prevalence) vs ____ smokers (incidence)
… people with breast cancer vs. new breast cancer cases
… fluoridated communities vs. communities that are becoming fluoridated
x
new x
new
Incidence
____/____
(within a specified period of ____)
new cases
population
time
Incidence vs Prevalence: HIV
• Progrsms that target people with HIV are different from thos tht target the \_\_\_\_ HIV people
____ have highest incidence of HIV
new
homosexual men
The ______ of disease is the proportion of existing cases of disease in a population at one point in time or during a specified period of time.
prevalnce
Easy statistics
Descriptive statistics describe a ____
Inferential statistics - ____ about your sample and to the broader population
population
generalizations
