Conservative Dentistry Department, College of Dentistry, Qassim University, Qassim, Saudi Arabia,
Evidence Based Healthcare, Centre of Evidence Based Medicine, University of Oxford, Oxford, UK,
J Multidiscip Healthc. 2019 Feb 11;12:131-136. doi: 10.2147/JMDH.S189484. eCollection 2019.
The primary objective of evidence-based practice is to improve the quality of health care. It helps in making a clinical decision based on recent and advanced research and the best available evidence. Evidence-based dentistry is an integration of best available evidence with clinical expertise and patient's needs and preferences. However, there are many barriers to apply evidence-based knowledge into practice. Information overflow, inability to select appropriate evidence, and critically appraising the evidence are the main challenges a practitioner may face. The focus of this review is defining a well-structured clinical question, key principles of literature search, type of search studies, and how to appraise an evidence. Furthermore, despite the availability of good evidence, patient's needs and preferences are crucial factors in making clinical decision. Finally, the clinician's experience and lack of motivation to change practice is another big challenge to evidence-based practice. This article discusses the six structured steps to apply evidence-based practice in dentistry with examples. Finally, this article will help practitioners to integrate their experience and skill with modern research evidence as well as to educate their patients to reach a final clinical decision.
循证医学实践的主要目标是提高医疗保健质量。它有助于基于最新和先进的研究以及最佳可得证据做出临床决策。循证牙科是将最佳可得证据与临床专业知识以及患者的需求和偏好相结合。然而,将循证知识应用于实践存在许多障碍。信息过载、无法选择合适的证据以及对证据进行批判性评估是从业者可能面临的主要挑战。本综述的重点是定义一个结构良好的临床问题、文献检索的关键原则、检索研究的类型以及如何评估证据。此外,尽管有良好的证据,但患者的需求和偏好是做出临床决策的关键因素。最后,临床医生的经验以及改变实践的动力不足是循证医学实践的另一个重大挑战。本文通过实例讨论了在牙科中应用循证医学实践的六个结构化步骤。最后,本文将帮助从业者将他们的经验和技能与现代研究证据相结合,并教育他们的患者以达成最终的临床决策。