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特殊人群的临床证据与循证牙科治疗:阿尔茨海默病患者

Clinical evidence and evidence-based dental treatment of special populations: patients with Alzheimer's disease.

作者信息

Chiappelli Francesco, Manfrini Ercolano, Edgerton Myeshia, Rosenblum Monica, Cajulis Kristine D, Prolo Paolo

机构信息

Division of Oral Biology and Medicine, University of California Los Angeles School of Dentistry, CA 90095, USA.

出版信息

J Calif Dent Assoc. 2006 Jun;34(6):439-47.

Abstract

This paper presents the novel domain of evidence-based research in the context of treating the dental needs of patients with special needs. A contrast is made between evidence-based dentistry and traditional dentistry, which is based on the evidence obtained by the dentist, with respect to the needs and the wants of the patient, and from the pertinent and accessible literature. By contrast, evidence-based dentistry is focused on integrating traditional dentistry with "the best available" research evidence. The aim of evidence-based dentistry is to improve clinical decision-making by its reliance on a critical analysis of the entire body of the published pertinent literature. It is a system of information management, and a system of data integration that assist clinicians in the process of meshing systemic clinical expertise, evidence provided by the patient, and the best literature evidence to enhance treatment outcomes. Evidence-based dentistry emphasizes rigorous analysis of evidence from clinical research, as the basis of sound dental practice, while discouraging intuitive and unsystematic approaches and promoting the systematic analysis and appraisal of the literature to determine the best treatment alternatives. In the case of patients with special needs, it is critical whether the dentist practices traditional dentistry or evidence-based dentistry to evaluate whether or not the patient is capable of expressing his or her needs/wants, unless, as in the more severe cases, he/she is accompanied by the caregiver. The purpose of this paper is to demonstrate the use of a simple in-house questionnaire for evaluating the patient's ability to tell the dentist his or her needs and wants accurately. In this context, the paper examines the dental needs of patients with dementia of the Alzheimer's type, DAT.

摘要

本文介绍了在满足特殊需求患者口腔治疗需求背景下基于证据的研究这一全新领域。基于证据的牙科与传统牙科形成对比,传统牙科是基于牙医获取的证据,涉及患者的需求与期望,并来源于相关且可获取的文献。相比之下,基于证据的牙科专注于将传统牙科与“最佳可得”研究证据相结合。基于证据的牙科的目标是通过依赖对已发表的全部相关文献进行批判性分析来改善临床决策。它是一个信息管理系统,也是一个数据整合系统,在将系统临床专业知识、患者提供的证据以及最佳文献证据相结合以提高治疗效果的过程中协助临床医生。基于证据的牙科强调对临床研究证据进行严格分析,作为合理牙科实践的基础,同时不鼓励直观和非系统的方法,而是促进对文献进行系统分析和评估以确定最佳治疗方案。对于特殊需求患者而言,关键在于牙医无论是采用传统牙科还是基于证据的牙科方法,都要评估患者是否有能力表达自己的需求和期望,除非在病情更严重的情况下,患者由护理人员陪同。本文的目的是展示如何使用一份简单的内部问卷来评估患者向牙医准确告知其需求和期望的能力。在此背景下,本文研究了阿尔茨海默病型痴呆(DAT)患者的口腔治疗需求。

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