Norton Wynne E, Funkhouser Ellen, Makhija Sonia K, Gordan Valeria V, Bader James D, Rindal D Brad, Pihlstrom Daniel J, Hilton Thomas J, Frantsve-Hawley Julie, Gilbert Gregg H
Dr. Norton is an assistant professor, Department of Health Behavior, School of Public Health, University of Alabama at Birmingham.
J Am Dent Assoc. 2014 Jan;145(1):22-31. doi: 10.14219/jada.2013.21.
Documenting the gap between what is occurring in clinical practice and what published research findings suggest should be happening is an important step toward improving care. The authors conducted a study to quantify the concordance between clinical practice and published evidence across preventive, diagnostic and treatment procedures among a sample of dentists in The National Dental Practice-Based Research Network ("the network").
Network dentists completed one questionnaire about their demographic characteristics and another about how they treat patients across 12 scenarios/clinical practice behaviors. The authors coded responses to each scenario/clinical practice behavior as consistent ("1") or inconsistent ("0") with published evidence, summed the coded responses and divided the sum by the number of total responses to create an overall concordance score. The overall concordance score was calculated as the mean percentage of responses that were consistent with published evidence.
The authors limited analyses to participants in the United States (N = 591). The study results show a mean concordance at the practitioner level of 62 percent (SD = 18 percent); procedure-specific concordance ranged from 8 to 100 percent. Affiliation with a large group practice, being a female practitioner and having received a dental degree before 1990 were independently associated with high concordance (≥ 75 percent).
Dentists reported a medium-range concordance between practice and published evidence.
Efforts to bring research findings into routine practice are needed.
记录临床实践中正在发生的情况与已发表的研究结果所表明的应该发生的情况之间的差距，是改善医疗护理的重要一步。作者开展了一项研究，以量化全国基于牙科实践的研究网络（“该网络”）中一组牙医在预防、诊断和治疗程序方面的临床实践与已发表证据之间的一致性。
网络牙医完成了一份关于其人口统计学特征的问卷，以及另一份关于他们在12种情况/临床实践行为中如何治疗患者的问卷。作者将对每种情况/临床实践行为的回答编码为与已发表证据一致（“1”）或不一致（“0”），对编码后的回答进行求和，并将总和除以总回答数，以创建一个总体一致性得分。总体一致性得分计算为与已发表证据一致的回答的平均百分比。
作者将分析限于美国的参与者（N = 591）。研究结果显示，从业者层面的平均一致性为62%（标准差 = 18%）；特定程序的一致性范围为8%至100%。隶属于大型团体诊所、女性从业者以及在1990年之前获得牙科学位与高一致性（≥ 75%）独立相关。
牙医报告称实践与已发表证据之间的一致性处于中等水平。
需要努力将研究结果应用于日常实践。
