ebp for d3s 2013-14
TRANSCRIPT
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EBP FOR D3s
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“
By all means let's be open-minded, but not soopen-minded that our brains drop out.”
~Richard Dawkins
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Learning Objectives
! Why write?
! The ABCs of EBP
! The D3 risk assessment portfolio evidence-based
PICO project
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Goals of D3 Patient Report
! Identify a patient who presents with a topic uniqueto practice of general dentistry
! Assess patient and record findings
! Assess proper course of care based on literature
review
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Why Write?
! Communication skills
! How much do you know?
! EBP
! Critical thinking
! Knowledge synthesis
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Are you sure?
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TMI
! MEDLINE:
! 4,000 journals
! 6 million references
! 400,000 new entries yearly
American Dental Association (2009). Final_EBD_-_Intro_for_Champions_120909. The Evidence-
Based Dentistry Champion Conference. ADA Headquarters, Chicago, IL.
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What is EBP? (NOT!)
! Evidence based practice is not. . .
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EBP According to the ADA
! “An approach to oral health care that requires
the judicious integration of systematic
assessments of clinically relevant scientific
evidence, relating to the patient's oral andmedical condition and history, with the dentist's
clinical expertise and the patient's treatment
needs and preferences.”
American Dental Association (n.d.) Evidence-Based Dentistry: Glossary of Terms. Retrieved March
5, 2009 from the World Wide Web: http://ada.org/prof/resources/ebd/glossary.asp#ebd
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What Does That Mean?
Decision
Patient’sneeds
Best
availableevidence
Practitioner’sclinical expertise
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What’s the Difference?
EBP! Best evidence
! Systematic search andappraisal
! Objective & unbiased
! Acceptable level ofuncertainty
BAU! Who needs evidence?
! Random search, limitedappraisal
! Subjective & potentially
biased
! Inappropriate level of
certainty
American Dental Association (2009). Final_EBD_-_Intro_for_Champions_120909. The Evidence-
Based Dentistry Champion Conference. ADA Headquarters, Chicago, IL.
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The Five “A”s of EBP
! Ask – Determine the clinical question
! Acquire – Systematically search the literature
! Appraise – Critically appraise the literature
! Apply – Make a decision
! Assess – Evaluate the results
Centre for Evidence-Based Dentistry (2007). Introduction to practising Evidence-based dentistry.
Retrieved March 5, 2009 from the World Wide Web: http://www.cebd.org/index.aspx?o=1007
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Evidence Based Written Project
! D3 – First 3 A’s
! Ask
! Acquire
! Appraise
! D4 – All 5 A’s
! Ask
! Acquire! Appraise
! Apply
! Assess
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Hierarchy of evidence
Retrieved January 12, 2010 from the World Wide Web: http://libguides.uttyler.edu/
content.php?pid=4904&sid=30812
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D3 Patient Report
! Ask – PICO format, identify clinical question
! Acquire – Identify search strategy
! Appraise – Literature analysis
! Synthesize
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A #1 – Asking Focused Questions
! Patient or Problem
! Intervention
! Comparison
! Outcomes
Centre for Evidence-Based Medicine (2009). Asking Focused Questions. Retrieved March 5, 2009
from the World Wide Web: http://www.cebm.net/index.aspx?o=1036
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PICO Example
! P – Adult human patients
! I – Chairside tooth whitening
! C – At-home tooth whitening
! O – Lighter teeth
h // di f i h d /
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http://medinformatics.uthscsa.edu/
EviDents
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Clinical Question
! In adult human patients, is chairside tooth
whitening more effective than at-home tooth
whitening in producing lighter teeth?
50 ld i ll d l
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"#$%&'(#)
*)+,-.,)(#) /#0$'-12#)
50 yr old partially edentulous
woman who smokes tobacco
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No!"#$%&'(#) 3 "'-('&&4
,5,)+%&#%2 '5%&+2 67#
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:#);20#8,-2
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Yes"#$%&'(#) 3 "'-('&&4
,5,)+%&#%2 '5%&+2 61+7
5,)+'& 10$&')+2*)+,-.,)(#) 3
<0#81)=
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Yes"#$%&'(#) 3 "'-('&&4
,5,)+%&#%2 '5%&+
20#8,-2
*)+,-.,)(#) 3
*0$&')+
/#0$'-12#) 3
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A #2 – Acquire
! Systematically search the literature
! PubMed
! Describe your search strategy
! Flowchart
! Appendix – screen capture search strategy
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Flowchart of Search Strategy
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A #3 - Appraise
! Critically appraise the literature
! LAFs – appendix
! At least one page per article – use effective prose
to convey empirical evidence
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Sections of the paper
! Introduction of clinical question
! Literature review
! Description of patient
! Discussion of positive findings
! Conclusion and recommendations for treatment,
based on literature
! References
! Appendices
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! Crop
! Remove extraneous
info
! HIPAA
Photography
! Retract
! Focus
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Photography
! http://iti.articulate-online.com/p/5051944432/DocumentViewRouter.ashx?
Cust=50519&DocumentID=b879d225-602e-4e3a-
a92c-3fe83a6e2654&Popped=True&&InitialPage=player.html
! Dr. Rebecca Poling
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Be thorough!
! Look for Preparation and Presentation of the D3Patient Report in Comprehensive Patient Care
syllabus
! Refer to grading sheet for format! Table of contents
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NYU Writing Center
! http://www.nyu.edu/cas/ewp/html/
writing_center.html
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PLAGIARISM!
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Turnitin.com
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Turnitin.com
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Turnitin.com
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Plagiarism Tutorial
! http://www.umuc.edu/writingcenter/plagiarism/
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Coherence
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Deadlines
! November 18, 2013 – PICO and Clinical question
! December 16, 2013 – Search strategy and articles
! January 21, 2014 – Risk Assessment Portfolio
Evidence-Based PICO Project due
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“If you always do what you’ve always done,then you always get what you always got.”
~Special Agent Anthony DiNozzo, (2006)
“Twisted Sister.
” NCIS, USA Network.
Brain Surgeon
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Brain SurgeonThat Mitchell & Webb Look , Series 3(2) - BBC Two
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Questions?