Division of Clinical Epidemiology, Kyushu Dental University, 2-6-1, Manazuru, Kokura-kita, Kitakyushu, Fukuoka, 803-8580, Japan; University of Florida College of Dentistry, Gainesville, FL, USA P.O. Box 100415, Gainesville, FL 32610-0415, USA.
Graduate School of Media and Governance, Keio University, 5322 Endo Fujisawa, Kanagawa, 252-0882, Japan.
J Dent. 2020 Nov;102:103469. doi: 10.1016/j.jdent.2020.103469. Epub 2020 Sep 9.
This study aimed to 1) quantify the evidence-practice gap (EPG) between dental clinical practice and published evidence on Minimal Intervention Dentistry (MID) among dentists in Japan; and 2) examine the hypothesis that dentist characteristics have a significant association with the EPG.
We conducted a cross-sectional study via use of a web-based questionnaire survey of dentists who were affiliated with the Dental Practice-based Research Network Japan (n = 297). To quantify the EPG on MID, we used a questionnaire that included 10 clinical questions or scenarios to assess concordance between dental practice and published evidence on MID. We evaluated concordance by coding responses to each question as consistent or inconsistent with the evidence. An overall concordance was then determined as percent of responses that were consistent with published evidence for 10 questions. Subsequently, multiple logistic regression analysis was conducted to examine the associations between dentist characteristics and higher overall concordance (≥median) with published evidence.
Mean and median overall dentist-level concordance were both 60 % (SD: 18, interquartile range: 50-75 %). Logistic regression analysis showed that "gender of dentist", "city population", and "frequency of obtaining evidence from the scientific journal articles in English" were significantly associated with high concordance, with odds ratios (95 % CIs) of 2.33 (1.01-5.39), 2.01 (1.02-3.96), and 2.45 (1.08-5.59), respectively.
Japanese dentists demonstrated medium concordance with published evidence, indicating that an EPG on MID exists in Japanese dental clinical practices. Dentist-specific characteristics had significant associations with high concordance with published evidence.
Despite the establishment and dissemination of the concept of MID, the EPG on MID exists in Japanese dental clinical practices. A high concordance was significantly associated with the following dentist characteristics: "female dentist", "dental clinic location in a government-ordinance-designated city", and "frequently obtaining evidence from the English-language scientific journal articles".
本研究旨在:1)量化日本牙医的口腔预防实践与已发表的最小侵入性牙科(MID)文献之间的证据-实践差距(EPG);2)检验牙医特征与 EPG 显著相关的假设。
我们通过使用基于网络的问卷对日本牙科实践研究网络(n=297)的牙医进行了横断面研究。为了量化 MID 的 EPG,我们使用了包含 10 个临床问题或情景的问卷,以评估口腔预防实践与 MID 发表证据之间的一致性。我们通过将每个问题的回答编码为与证据一致或不一致来评估一致性。然后,将 10 个问题的一致反应百分比确定为整体一致性。随后,进行多因素逻辑回归分析,以检验牙医特征与更高的整体一致性(≥中位数)与发表证据之间的关联。
牙医的平均和中位数整体一致性均为 60%(SD:18,四分位距:50-75%)。逻辑回归分析表明,“牙医的性别”、“城市人口”和“从英文科学期刊文章中获取证据的频率”与高一致性显著相关,优势比(95%置信区间)分别为 2.33(1.01-5.39)、2.01(1.02-3.96)和 2.45(1.08-5.59)。
日本牙医与发表的证据有中等程度的一致性,这表明在日本口腔临床实践中存在 MID 的 EPG。牙医的具体特征与与发表证据的高一致性显著相关。
尽管已经确立并传播了 MID 的概念,但 MID 的 EPG 仍存在于日本的口腔临床实践中。高一致性与以下牙医特征显著相关:“女牙医”、“位于政府指定城市的牙科诊所”和“经常从英文科学期刊文章中获取证据”。