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Randomised clinical trials and evidence-based general dentistry
Linköping University, Department of Department of Health and Society. Linköping University, Faculty of Health Sciences.
2004 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

A growing number of scientific publications and new treatment modalities have increased the difficulties of keeping up to date with the latest research evidence in clinical practice. Therefore, evidence-based dentistry and medicine (EBDM) has evolved as an attempt to summarise current best evidence.

The overall aim of this thesis was to study the availability and the methodological quality of randomised controlled trials (RCTs) in dental (RCT-Ds) and medical (RCT-Ms) research, and publications describing epidemiological registration methods of dental caries. It also examines the applicability of evidence-based methods to general dental practice.

The most important findings were that the armual number of publications in dental research showed a decreasing trend from 1969 to 1999, whereas medical research increased. The armual number of clinical trials (CTs), meta-analyses and RCTs increased, but represented just a fraction of all publications in both dental and medical research. Medical subject heading (MeSH) searches provided an overall adequate method for rapid location of RCT-Ds on Medline for most areas of dental research. The quality of RCT-Ds and RCT-Ms were generally inadequate. There was no correlation between the quality of RCTs and Journal Impact Factor. The armual number of publications, CTs and RCTs in periodontal research (RCT-Ps) increased during 1980-2000. A few clinical research areas dominated the RCT-Ps. Most of the RCT-Ps were published in just two different dental journals. Validation methodology in publications describing epidemiological methods for registering dental caries was inadequate according to EBDM recommendations and needs to be improved.

Place, publisher, year, edition, pages
Linköping: Linköpings universitet , 2004. , 57 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 865
Keyword [en]
Dental care, dental research, epidemiological methods, evidence-based medicine, Medline, randomized controlled trials, validity
National Category
Social Sciences
Identifiers
URN: urn:nbn:se:liu:diva-22686Local ID: 1978ISBN: 91-7373-839-5 (print)OAI: oai:DiVA.org:liu-22686DiVA: diva2:242999
Public defence
2004-11-12, Aulan, Hälsans Hus, Hälsouniversitetet, Linköping, 13:00 (Swedish)
Opponent
Available from: 2009-10-07 Created: 2009-10-07 Last updated: 2012-10-29Bibliographically approved
List of papers
1. Trends in dental and medical research and relevance of randomized controlled trials to common activities in general dentistry
Open this publication in new window or tab >>Trends in dental and medical research and relevance of randomized controlled trials to common activities in general dentistry
2000 (English)In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 58, no 6, 260-264 p.Article in journal (Refereed) Published
Abstract [en]

The aim was to study publication trends in dental and medical research as well as the proportion of randomized controlled trials in dental research (RCT-Ds) of relevance to common activities in general dentistry. The study was based on Medline searches, 1969-99 (MeSH terms). Data from Public Dental Services (county of Östergötland, Sweden) were used to find the most common activities in the practice of general dentistry. In dental research the annual number of publications had decreased from 5,900 in 1969 to 4,400 in 1999, corresponding to 9,100 and 14,000, respectively, in medical research. Clinical trials in dental research had increased to 7% and RCT-Ds to 5% of all dental research during 1969-99. In medicine, clinical trials and randomized controlled trials had increased to 2% and 1%, respectively. In dental and medical research, meta-analyses (MAs) totalled 0.1-0.2% in 1994 and 1999. One out of 200 dental research publications in 1979-99 was an RCT-D of relevance to the most common activities in general dentistry. These activities contributed to more than 80% of the dental care of children and adolescents and to more than 60% of the dental care of adults in 1999.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-47530 (URN)10.1080/00016350050217109 (DOI)
Available from: 2009-10-11 Created: 2009-10-11 Last updated: 2017-12-13
2. Medline search validity for randomised controlled trials in different areas of dental research
Open this publication in new window or tab >>Medline search validity for randomised controlled trials in different areas of dental research
2002 (English)In: British Dental Journal, ISSN 0007-0610, E-ISSN 1476-5373, Vol. 192, no 2, 97-99 p.Article in journal (Refereed) Published
Abstract [en]

Objective To determine the validity of Medline searches for randomised controlled trials in dental research (RCT-Ds), using the medical subject headings (MeSH-terms).

Design The Medline database was searched for randomised controlled trials in dental research (RCT-Ds) published in 1999 and with MeSH-terms corresponding to different areas of dental research. All RCT-Ds were manually examined for relevance to the different areas of dental research and cross-tabulated against the Medline search results. The sensitivity, specificity, positive (precision) and negative predictive values, as well as the accuracy of the search results were calculated.

Results The highest validity in the Medline searches for RCT-Ds was seen for endodontics, followed by orthodontics, whereas the lowest validity was seen for pediatric dentistry and public health dentistry. For pediatric dentistry the MeSH-term searches had too low a sensitivity for adequate location of RCT-Ds.

Conclusions MeSH-term searches on Medline are a useful tool for rapid location of RCT-Ds in most areas of dental research. However, there is a vast variation in the search validity. More refined search strategies are required to locate RCT-Ds in areas of dental research with low search validity.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-84948 (URN)10.1038/sj.bdj.4801303 (DOI)
Available from: 2012-10-29 Created: 2012-10-29 Last updated: 2017-12-07
3. Quality of reporting randomised clinical trials in dental and medical research
Open this publication in new window or tab >>Quality of reporting randomised clinical trials in dental and medical research
2002 (English)In: British Dental Journal, ISSN 0007-0610, E-ISSN 1476-5373, Vol. 192, no 2, 100-103 p.Article in journal (Refereed) Published
Abstract [en]

Objective To assess 1) the quality of reporting randomised clinical trials in dental (RCT-Ds) and medical research (RCT-Ms), 2) the quality of RCT reports in relation to the journal impact factor, 3) the source of funding, and 4) the quality of RCT-Ds in different areas of dental research.

Design Random samples of 100 RCT-Ds and 100 RCT-Ms published in 1999 were evaluated for quality of reporting under blinded conditions with the Jadad quality assessment scale. In addition, correlation between the quality scores and journal impact factor or source of funding, as well as area of dental research were analysed.

Results The quality of RCT-Ds and RCT-Ms published in 1999 was generally inadequate. The quality was largely equivalent in RCT-Ds and RCT-Ms. There was no correlation between the quality scores and the journal impact factor or the source of funding. Some differences were found in the quality scores between different areas of dental research.

Conclusions The results from these RCT-Ds and RCT-Ms show that most of them were imperfect in the reporting of methodology and trial conduct. There is a clear need to improve the quality of trial reporting in dental and medical research.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-84950 (URN)10.1038/sj.bdj.4801304 (DOI)
Available from: 2012-10-29 Created: 2012-10-29 Last updated: 2017-12-07
4. Randomised controlled trials and publication trends in periodontal research during 1980–2000
Open this publication in new window or tab >>Randomised controlled trials and publication trends in periodontal research during 1980–2000
2002 (English)In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 29, no 12, 1112-1117 p.Article in journal (Refereed) Published
Abstract [en]

Objectives:  To study publication trends, as well as the number and proportion of randomised controlled trials covering different areas of periodontal research (RCT-Ps).

Material and methods:  The study was based on Medline searches (MeSH terms) for the period 1980– 2000. The RCT-Ps (n = 675) were examined for relevance for different areas of periodontal research, journals of publication, and the countries of origin.

Results:  In periodontal research the annual number of publications had increased from 162 in 1980 to 440 in 2000. Moreover, clinical trials in periodontal research (CT-Ps) had increased more than 10-fold, and RCT-Ps more than 15-fold. More than 4 out of 10 RCT-Ps covered the areas ‘periodontal surgery’ and ‘gingivitis and plaque treatment or prevention’. More than 6 out of 10 RCT-Ps in total and more than 8 out of 10 RCT-Ps about ‘periodontal surgery’, were published in two different journals. U.S.A was the most common country of origin of RCT-Ps, contributing to almost 4 out of 10 RCT-Ps during 1988– 2000.

Conclusion:  The annual number of RCT-Ps increased substantially during 1980–2000, and a few clinical research areas predominated. Future research should give priority to areas where clinical evidence is scarce and where high-quality RCT-Ps are most needed.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-84951 (URN)10.1034/j.1600-051X.2002.291211.x (DOI)
Available from: 2012-10-29 Created: 2012-10-29 Last updated: 2017-12-07
5. Validation methodology in publications describing epidemiological registration methods of dental caries: a systematic review
Open this publication in new window or tab >>Validation methodology in publications describing epidemiological registration methods of dental caries: a systematic review
2003 (English)In: Community Dental Health, ISSN 0265-539X, Vol. 20, no 4, 251-259 p.Article in journal (Refereed) Published
Abstract [en]

Objective: The aim was to describe and systematically review the methodology and reporting of validation in publications describing epidemiological registration methods for dental caries.

Basic research methodology: Literature searches were conducted in six scientific databases. All publications fulfilling the predetermined inclusion criteria were assessed for methodology and reporting of validation using a checklist including items described previously as well as new items. The frequency of endorsement of the assessed items was analysed. Moreover, the type and strength of evidence, was evaluated.

Main outcome measures: Reporting of predetermined items relating to methodology of validation and the frequency of endorsement of the assessed items were of primary interest.

Results: Initially 588 publications were located. 74 eligible publications were obtained, 23 of which fulfilled the inclusion criteria and remained throughout the analyses. A majority of the studies reported the methodology of validation. The reported methodology of validation was generally inadequate, according to the recommendations of evidence-based medicine. The frequencies of reporting the assessed items (frequencies of endorsement) ranged from four to 84 per cent. A majority of the publications contributed to a low strength of evidence.

Conclusion: There seems to be a need to improve the methodology and the reporting of validation in publications describing professionally registered caries epidemiology. Four of the items assessed in this study are potentially discriminative for quality assessments of reported validation.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-84952 (URN)14696746 (PubMedID)
Available from: 2012-10-29 Created: 2012-10-29 Last updated: 2017-12-07

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