Schneider Lindsey A, Carney Patrick C, Eldermire Erin R B, Fiani Nadine, Peralta Santiago
Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, United States.
Flower-Sprecher Veterinary Library, Cornell University, Ithaca, NY, United States.
Front Vet Sci. 2020 Jul 31;7:454. doi: 10.3389/fvets.2020.00454. eCollection 2020.
Veterinary dentistry and oral surgery are relatively new clinical disciplines that have rapidly evolved in the last few decades. Although clinical standards of care are supported by a growing body of literature, the extent to which peer-reviewed, evidence-based studies have contributed to advancing the practice of dentistry and oral surgery has not been assessed. The purpose of this study was to survey literature on the clinical practice of small animal dentistry and oral surgery published over the past 40 years to evaluate the levels of evidence over time, authorship affiliation, funding, and clinical subdisciplines within the field. A literature search was conducted in PubMed and the identified articles were screened for inclusion. A total of 1,083 articles were included for final analysis. Three reviewers independently assessed and assigned each article to one of nine predetermined study design categories. Systematic reviews and meta-analyses were considered the highest level of evidence, whereas expert opinion and experimental (, or ) studies were deemed the lowest levels of evidence. For statistical analysis and interpretation, study type was dichotomized into high evidence designs from which causal inference and/or associations could be derived, and low evidence designs which were purely descriptive or non-clinical experiments. No statistically significant difference in the distribution of study type was seen over time, with the majority of research in the last 5 years being largely at high risk of bias and descriptive in nature: 80.6% of articles published between 2014 and 2019 were assigned to the low evidence design tier. The type of study was found to differ by author affiliation: high evidence study designs were found more often than expected when author affiliation was multi-institutional or industrial, whereas private practice authorship was underrepresented in the high evidence design tier. To meet the increasing demand for evidence-based studies on the practice of dentistry and oral surgery in dogs and cats, researchers are encouraged to consider study design when testing hypotheses to improve the quality of research.
兽医牙科学与口腔外科学是相对较新的临床学科，在过去几十年中迅速发展。尽管越来越多的文献支持临床护理标准，但同行评审的、基于证据的研究对推进牙科学与口腔外科学实践的贡献程度尚未得到评估。本研究的目的是调查过去40年发表的关于小动物牙科学与口腔外科学临床实践的文献，以评估不同时期的证据水平、作者所属机构、资金来源以及该领域内的临床子学科。在PubMed上进行了文献检索，并对检索到的文章进行筛选以确定是否纳入。共有1083篇文章纳入最终分析。三位评审员独立评估每篇文章，并将其分配到九个预先确定的研究设计类别之一。系统评价和荟萃分析被认为是最高证据水平，而专家意见和实验性（或）研究被视为最低证据水平。为了进行统计分析和解释，将研究类型分为可得出因果推断和/或关联的高证据设计，以及纯粹描述性或非临床实验的低证据设计。随着时间的推移，研究类型的分布没有统计学上的显著差异，过去5年的大多数研究在很大程度上存在高偏倚风险且本质上是描述性的：2014年至2019年发表的文章中有80.6%被分配到低证据设计类别。研究发现，研究类型因作者所属机构而异：当作者所属机构为多机构或行业时，高证据研究设计的出现频率高于预期，而在高证据设计类别中，私人执业作者的代表性不足。为了满足对犬猫牙科学与口腔外科学实践的循证研究日益增长的需求，鼓励研究人员在检验假设时考虑研究设计，以提高研究质量。
