Evidence-based Dentistry (EBD) is a method for rapidly aggregating, distilling and implementing the best evidence in clinical practice. To accomplish a successful EBD it requires the integration of the best clinical practice, clinical judgement together with patient’s values and circumstances to improve healthcare.
The development of the evidence-based dentistry were delayed as an approach to healthcare, although this delayed had been a main driver for the development of EBD nowadays. The early development of EBD was criticised for focusing on evidence from randomised controlled trials and systematic reviews of evidence, but the past decade has been development of systematic review methodology for a range of study designs. The availability of high-quality systematic reviews is increasing through the work of groups and increased use of these reviews will improve the quality of evidence available for decision-making.
Clinical expertise is a key element and this can and will vary significantly. Experience in providing one type of treatment or using certain materials, procedures or equipment’s will vary.
Patient’s values play a crucial rule in evidence-based practice, but articulating these values is a challenge for some of them. It is important to recognise the major stakeholders for value system which are involved in clinical decision (the patients, the dentist and the third-party payer). Recognising this, and engaging patients in simultaneous discussion about values, evidence and clinical judgment will help improve the quality of the provided care.
The main reason to implement EBD is to improve the quality of care, another factor has been the increasing involvement of patients in healthcare decision-making. The driver for this is the enormous amount of information that is available today which is in the form of books, journals and the internet.
Evidence-based Practice is a set of methods for rapidly aggregating, distilling and implementing the best clinical information in clinical practice. The approach consist of five steps which are:
- Asking answerable questions
- Searching for the best evidence.
- Critically appraising the evidence.
- Applying the evidence.
- Evaluating the evidence.
While most clinical will not engage in developing evidence, they can relatively easily become effective user of evidence.
In conclusion Evidence-based Practice is a structural approach for clinical decision-making that assists the practitioners in finding, distilling and applying the best evidence in clinical practice by managing the problem of information overload and uncertainty.
Adapted from Evidence-based Dentistry: Managing information for Better Practice
Richards, D. (2007). Evidence-based dentistry. London: Quintessence.
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