DTL 507 Evidence Informed Practice Intro week 1- student PDF

DTL 507 Evidence Informed Practice COURSE INTRODUCTION  Instructor: Prof. Carmen Clayton cclayton @stclaircollege.ca Textbooks: ◦ Forrest JL. (2018) Evidence-based decision making: introduction and formulating good clinical questions. [Internet]. Dentalcare.com; 2018. Posted on Blackboa...

DTL 507 Evidence Informed Practice COURSE INTRODUCTION  Instructor: Prof. Carmen Clayton cclayton @stclaircollege.ca Textbooks: ◦ Forrest JL. (2018) Evidence-based decision making: introduction and formulating good clinical questions. [Internet]. Dentalcare.com; 2018. Posted on Blackboard ◦ Frantsve-Hawley, J. (2014). Evidenced-Based Dentistry for the Dental Hygienist. Chicago, Illinois: Quintessence Publishing Co. Course Outline Course Course Assessments Comprehensive Final Exam – 40% - Date TBA (Exam Week Dec. 9-13) Assignments – 60% Reading Research – 5% Reflective practice – LEARN – 10% Major Assignment - Evidence Informed Practice – 45% Part A – PICO question (10%) Part B – Literature review & discussion (30%) Part C – Group Presentations (5%) Reading Research Assignment Work individually or in pairs. Read the assigned research article Complete the chart.  Major Assignment – Evidence informed practice 3-part assignment 1. Identify an issue of relevance to dental hygiene and formulate a clinical question. Locate and review the research evidence surrounding the issue in order to answer the question. 2. Synthesize the evidence and discuss their conclusions and the significance of their conclusion to the profession in a written essay. 3. Findings will be shared through a presentation and handout. Course Description This course will build on a basic knowledge of statistics as it relates to the principles and methods used in health research. The student will examine the use of scientific research in professional practice. The student will also learn to critically appraise scientific articles and make clinical decisions using an evidence-based process. Finally, the student will disseminate information in writing and orally. WHY? What do you think are the components that comprise the dental knowledge base? Evolution of dental knowledge base Concepts of what constituted “evidence” throughout the four eras of the dental knowledge base Evidence-based VS Evidence- informed Evidence-Based ◦Comes originally from medical science (McMaster Univ) ◦Implies that best answer always lies in research findings ◦Evidence-Informed ◦Makes use of research to contribute new knowledge ◦Recognizes that sometimes research is not available or incomplete ◦Recognizes that other factors should influence decision-making, such asvalues, resource availability and clinical experience.  Most recent writing about Evidence-Based Practice has expanded the view to include other factors, so the difference between the two is lessening  Principle drivers of evidence- based movement Archie Cochrane: Scottish physician and epidemiologist who advocated application of scientific methods, especially RCTs to evaluate effectiveness and efficiency of medical treatments. The Cochrane Collaboration is an international network of volunteers that prepares and updates systematic review on a variety of topics as well as maintains the largest collection of records of RCTs in the world. David Sackett: Created the term evidence-based medicine at McMaster (1990) this drove research and enabled us to provide the best treatment for our clients based off the evidence found. Best evidence: term evolved from EBM movement associated with a rigorous process for finding the least biased information pertinent to an individual patient’s treatment Evidence Informed Decision Making Is all evidence created equal? - NO - Selection process of the subjects. Is it a scenario, not everyone will be the same.  Best evidence Validity: how accurately the evidence reflects what is true; an essential characteristic of evidence. Bias: the existence of factors or processes that can influence the results or conclusions of a trial. How does bias occur? - Different types of bias, when reading the articles keep this in mind for potential for bias. Could they have done something differently? Questions asked within the research? This may be found in the data portion. Research designs have become increasingly sophisticated over time: single observer  RCT Purpose of this maturation is to reduce risk of bias in information or evidence Levels of evidence for preventive or therapeutic studies Peer Reviewed, Multiple articles, Comparing and contrasting. Strict protocalls One person reviewed The advantages of a systematic review. A systematic review uses scientific methodology to systematically identify all relevant literature around a clinical question, critically appraise the studies, evaluate the data, and develop conclusions. A high-quality systematic review is a reliable source of valid information for clinical decision making. 5 steps of using EIDM 5 steps of using EIDM PICO process Converting information needs/problems into a clinical question that can be answered. Asking the right questions is fundamental to the Evidence Informed Decision-Making Process. PICO format P: Problem or disease of interest (Can be Population) I: Intervention or treatment in question C: Comparison treatment (alternative treatment) O: Outcome through which the intervention and comparison treatment will be evaluated Writing the PICO Question P: “In a patient with …………..” “For [specific client group]….. I: “will [specific treatment/action] ……………” C: “as compared to [alternate or no action] …………” O: “result in [specific result] …………….” “be effective in [specific result]…..” Example: “In a patient with mild gingivitis, will rinsing with antiseptic mouthwash as compared with flossing be as effective in reducing plaque” (not well worded) - Generating a question with research - Based off the two articles narrow the research down (condensed) Example: Your client, Angela, says she heard that you could whiten your teeth at home using hydrogen peroxide. She wants to know if it is better than buying whitening strips.  What background questions would be appropriate about her teeth-whitening concerns? What would be sources of information to answer these questions?  Background question summary  PICO question for Angela P: I: C: O: Type of question: therapy/prevention