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Dental Assisting, Hygiene, and Laboratory Technology

Information resources for SUNY Erie dental studies students and those seeking information on oral health

What is Evidence-Based Practice?

Evidence-based practice is the integration of a clinician's expertise supported by evidence-based research and informed by a patient's values and preferences.  

                                                  

    "What is Evidence-Based Practice?"

by Duke University Medical Center is licensed under CC BY-NC-SA 4.0

What are Evidence-Based Resources?

Evidence-based resources are comprised of research studies and randomized controlled trials, critically appraised topics and articles, and systematic reviews that are used directly in the creation of clinical practice guidelines.  

The evidence pyramid, pictured below, depicts the theoretical level of the quality of evidence for each type of resource.

Image of the Evidence Pyramid. Depicts the theoretical hierarchy of quality in information types as they pertain to evidence based medicine. The highest in the hierarchy are Clinical Practice Guidelines. Second in the hierarchy are Systematic Reviews. Third in the hierarchy are Critically-Appraised Topics [Evidence Syntheses]. Fourth in the hierarchy are Critically-Appraised Individual Articles [Article Synopses]. Fifth in the hierarchy are Randomized Controlled Trials (RCTs). Sixth in the hierarchy are Cohort Studies. Seventh in the hierarchy are Case-Controlled Studies and Case Series / Reports. Eighth, and lowest in the hierarchy, are Background Information and Expert Opinions.

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Transforming a Clinical Scenario into a Database Search Strategy

Clinical Scenario (slide 1 of 7)

You will usually begin your research with a clinical scenario:

Mark McGee – a 70-year-old male – is concerned about his bad breath.  You tell him that he wouldn’t have much to be concerned about if he only brushed his teeth. He doesn’t believe you and says, “show me the evidence!”  

Then you should use PICO, synonyms, & boolean operators to create a well-defined search question and search strategy.

 

These slides are derived from content that originally appeared in University of Michigan Library's Dentistry Research Guide: guides.lib.umich.edu/dentistry, accessed 15 Oct. 2021. This content is protected by a Creative Commons Attribution 4.0 license.

The PICO Model (slide 2 of 7)

The PICO model helps you create an answerable question from a clinical scenario by identifying search terms & their relationships so that you can conduct an effective literature search.

P =   patient/population/problem
Who is the patient?  What are the significant characteristics (age, gender, dental problem)?
I =    Intervention
What will you do:  educate the patient, provide a dental device, drug? 
C =   Comparison
Is  there a comparison to the intervention?  Optional. 
O =   Outcome
What do you want to achieve:  Improve oral health, reduce symptoms, improve patient compliance?

Filling in the PICO Model (slide 3 of 7)

Based on the clinical scenario:

  • P =   male, adult, bad breath
  • I =     toothbrushing
  • C =   doing nothing
  • O =   reduction in bad breath

Not all of these terms will be used directly in the search, but it's good to be aware of all potential search terms.

Research Question (slide 4 of 7)

Here's the question that you'll base your search on.

Does toothbrushing, in comparison with doing nothing [i.e., what the patient is currently doing], decrease bad breath in older male adults?

Synonyms (slide 5 of 7)

Synonyms, words that mean the same thing or are closely related to each other, can help expand your search appropriately. 

For this search, the synonyms are:

bad breath      

 halitosis

 toothbrushing    

oral hygiene

 

You could also use terms such as mouth rinses or toothpaste.

Boolean Operators (slide 6 of 7)

Boolean operators such as AND & OR are used to connect synonyms & concepts.

  • Use OR to connect synonyms to appropriately expand your search for a concept. Your search results will contain citations for each term.  Place parentheses around the search terms when you use OR so that the database searches them together. 
  • Use AND to connect concepts.  This will narrow your search results, giving you just the articles that include all terms, that is,  the intersection of the search terms you've used.  Remember:  Databases assume AND between terms, so you don't have to use it.
  • Always capitalize boolean operators; if you don't, they'll be ignored.

Putting It All Together (slide 7 of 7)

Here are the terms (also known as a "search strategy") that will be used to search the database:

  (bad breath OR halitosis) AND (toothbrushing OR oral hygiene)

Bad breath & halitosis are synonyms for one concept, so they're connected by OR & placed within parentheses.

Toothbrushing & oral hygiene are synonyms for the second concept.  They're connected to the first concept with AND.

How do I search for Evidence-Based Resources?

There are both Library resources and Web resources for searching for evidence-based practices (EBP).  The difference for you is that many of the library resources will be immediately available for you in full-text.  Resources found in other EBP resources may need to be requested via Interlibrary Loan. 
LIBRARY-BASED RESOURCES
Recommended Article Databases

Using the search options described above will focus your search results to information under the category of evidence-based medicine. This includes articles from evidence based practice journals, articles about evidence based practice, research articles (including systematic reviews, clinical trials, meta analysis, qualitative studies), commentaries on research studies, and case studies (if they meet the criteria of the use of research and/or evidence based practice terms).

More nuanced search results may be received by including the following phrases with your initial search concept:

"practice guideline"
"systematic review"
"meta-analysis"
"critically appraised topics"
"randomized controlled trial"
"cohort studies"
"case control studies" 

Evidence-Based Resources on the Internet

Research Articles, Systematic Reviews, and Meta Analyses

Critically Appraised Topics