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Cunha-Cruz J, Gilbert GH, Allareddy V, Cochran DL, Fellows J, Kopycka-Kedzierawski DT, McBurnie M, Meyerowitz C, Mungia R, Rindal DB, Gordan VV. Characteristics of dentists in the National Dental Practice-Based Research Network. J Dent 2023; 137:104653. [PMID: 37572986 PMCID: PMC10528504 DOI: 10.1016/j.jdent.2023.104653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 08/08/2023] [Indexed: 08/14/2023] Open
Abstract
OBJECTIVES Our aims are to describe the characteristics of dentists, members of the US National Dental practice-based research network (PBRN) in the United States, and determine how often these dentists provide specific dental procedures. METHODS Dentists completed a questionnaire when they enrolled in the Network about their demographic and training characteristics and characteristics of their practices and patients. Dentists also reported the frequency of providing specific dental procedures. Data were analyzed using descriptive statistics. RESULTS Of 4,483 dentists in active clinical practice, 34% identified as females, 70% as white, and 73% as general dentists. Most dentists practiced in large metropolitan areas (87%) and in solo or small practices (72%). On average, they reported about one-half of their patients were children or older adults, a third were from historically underrepresented racial and ethnic groups, and one-quarter were covered by public insurance. Most dentists routinely performed restorations and fixed prosthetics (78%), extractions (59%), removable (44%) and implant (40%) prosthetics, and endodontics on incisor and premolar teeth (44%). CONCLUSIONS Dentists participating in the National Dental PBRN have much in common with dentists at large. The network has a broad representation of dentists, practice types, patient populations, and treatments offered, including diversity regarding race/ethnicity, gender, insurance, and geography of its practitioners and patients. CLINICAL SIGNIFICANCE Characteristics of National Dental PBRN dentists suggest that a broad range of dentists is interested in participating in national-level research studies, thereby enabling an array of clinical study settings and topics that can optimize the generalizability of study findings.
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Affiliation(s)
- Joana Cunha-Cruz
- Department of Clinical and Community Sciences, School of Dentistry, University of Alabama at Birmingham, Medical Towers Suite 402, 1717 11th Avenue South, Birmingham, AL 35205, United States.
| | - Gregg H Gilbert
- Department of Clinical and Community Sciences, School of Dentistry, University of Alabama at Birmingham, Medical Towers Suite 402, 1717 11th Avenue South, Birmingham, AL 35205, United States
| | - Veerasathpurush Allareddy
- University of Illinois Chicago College of Dentistry, 801 S. Paulina Street, Chicago, Illinois 60612, United States
| | - David L Cochran
- Department of Periodontics, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, United States
| | - Jeffrey Fellows
- Center for Health Research, Kaiser Permanente, 3800N. Interstate Avenue, Portland, OR 97227-1098, United States
| | - Dorota T Kopycka-Kedzierawski
- Eastman Institute for Oral Health, University of Rochester, 625 Elmwood Ave, PO Box 683, Rochester, NY 14620, United States
| | - MaryAnn McBurnie
- Kaiser Permanente Center for Health Research, 3800N. Interstate Avenue, Portland, OR 97114, United States
| | - Cyril Meyerowitz
- Eastman Institute for Oral Health, University of Rochester. 601 Elmwood Avenue, Box 686, Rochester, NY 14642, United States.
| | - Rahma Mungia
- Department of Periodontics, The University of Texas Health San Antonio, 8403 Floyd Curl Drive; MC 8258; Suite 300.29, San Antonio, TX 78229, United States
| | - D Brad Rindal
- HealthPartners Institute, HealthPartners Dental Group, 8170 33rd Avenue South | P.O. Box 1524, MS 21112R, Minneapolis MN 55440-1524, United States
| | - Valeria V Gordan
- University of Florida College of Dentistry, Restorative Dental Sciences Department, PO Box 100415, Gainesville FL 32610-0415, United States
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Kalenderian E, White J, Yansane AI, Urata J, Holmes D, Funkhouser K, Mungia R, Xiao J, Rauschenberger C, Ibarra-Noriega A, Tran D, Rindal DB, Spallek H, Walji M. Study protocol: understanding pain after dental procedures, an observational study within the National Dental PBRN. BMC Oral Health 2022; 22:581. [PMID: 36494795 PMCID: PMC9733211 DOI: 10.1186/s12903-022-02573-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 11/08/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Patient-reported outcome measures provide an essential perspective on the quality of health care provided. However, how data are collected, how providers value and make sense of the data, and, ultimately, use the data to create meaningful impact all influence the success of using patient-reported outcomes. OBJECTIVES The primary objective is to assess post-operative pain experiences by dental procedure type through 21 days post-procedure as reported by patients following dental procedures and assess patients' satisfaction with pain management following dental surgical procedures. Secondary objectives are to: 1) assess post-operative pain management strategies 1 week following dental surgical procedures, as recommended by practitioners and reported by patients, and 2) evaluate practitioner and patient acceptance of the FollowApp.Care post visit patient monitoring technology (FollowApp.Care). We will evaluate FollowApp.Care usage, perceived usefulness, ease of use, and impact on clinical workload. DESIGN AND METHODS We describe the protocol for an observational study involving the use of the FollowApp.Care platform, an innovative mobile application that collects dental patients' assessments of their post-operative symptoms (e.g., pain). The study will be conducted in collaboration with the National Dental Practice-based Research Network, a collective Network of dental practices that include private and group practices, public health clinics, community health centers and Federal Qualified Health Centers, academic institutional settings, and special patient populations. We will recruit a minimum of 150 and up to 215 dental providers and up to 3147 patients who will receive push notifications through text messages FollowApp.Care on their mobile phones at designated time intervals following dental procedures. This innovative approach of implementing an existing and tested mobile health system technology into the real-world dental office setting will actively track pain and other complications following dental procedures. Through patients' use of their mobile phones, we expect to promptly and precisely identify specific pain levels and other issues after surgical dental procedures. The study's primary outcome will be the patients' reported pain experiences. Secondary outcomes include pain management strategies and medications implemented by the patient and provider and perceptions of usefulness and ease of use by patients and providers.
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Affiliation(s)
- Elisabeth Kalenderian
- grid.424087.d0000 0001 0295 4797Academic Center for Dentistry at Amsterdam (ACTA), Gustav Mahlerlaan 3004, Room 6N-09, 1081 Amsterdam, LA The Netherlands ,grid.266102.10000 0001 2297 6811University of California San Francisco, School of Dentistry, 600 Parnassus Avenue, San Francisco, CA USA ,grid.38142.3c000000041936754XHarvard School of Dental Medicine, Boston, MA USA ,grid.49697.350000 0001 2107 2298University of Pretoria, School of Dentistry, Pretoria, South Africa
| | - Joel White
- grid.266102.10000 0001 2297 6811University of California San Francisco, School of Dentistry, 600 Parnassus Avenue, San Francisco, CA USA
| | - Alfa-Ibrahim Yansane
- grid.266102.10000 0001 2297 6811University of California San Francisco, School of Dentistry, 600 Parnassus Avenue, San Francisco, CA USA
| | - Janelle Urata
- grid.266102.10000 0001 2297 6811University of California San Francisco, School of Dentistry, 600 Parnassus Avenue, San Francisco, CA USA
| | - David Holmes
- FollowApp.Care, London, England ,Private Dental Practice, Periodontics and Implant Dentistry, 19 Wimpole St, W1G 8GE London, London UK
| | - Kimberly Funkhouser
- grid.414876.80000 0004 0455 9821Kaiser Permanente Center for Health Research, 3800 N. Interstate Avenue, Portland, OR 97227-1098 USA
| | - Rahma Mungia
- UTHealth San Antonio, School of Dentistry, San Antonio, TX USA
| | - Jin Xiao
- Department of Dentsitry, Eastman Institute for Oral Health, National Dental PBRN, 625 Elmwood Ave, Box 683, Rochester, NY 14620 USA
| | - Cindy Rauschenberger
- Department of Dentsitry, Eastman Institute for Oral Health, National Dental PBRN, 625 Elmwood Ave, Box 683, Rochester, NY 14620 USA
| | - Ana Ibarra-Noriega
- grid.267308.80000 0000 9206 2401The University of Texas Health Science Center at Houston, School of Dentistry, Diagnostic and Biomedical Sciences, Research Office, 7500 Cambridge Street, room 4334, Houston, TX 77054 USA
| | - Duong Tran
- grid.267308.80000 0000 9206 2401The University of Texas Health Science Center at Houston, School of Dentistry, Diagnostic and Biomedical Sciences, Research Office, 7500 Cambridge Street, room 4334, Houston, TX 77054 USA
| | - D. Brad Rindal
- grid.280625.b0000 0004 0461 4886HealthPartners Institute for Education and Research, 8170 33rd Avenue South, P.O. Box 1524, MS 23301A, Bloomington, MN 55440-1524 USA
| | - Heiko Spallek
- grid.1013.30000 0004 1936 834XUniversity of Sydney, School of Dentistry, 2 Chalmers St., Surry Hills, Sydney, NSW 2010 Australia
| | - Muhammad Walji
- grid.267308.80000 0000 9206 2401The University of Texas Health Science Center at Houston, School of Dentistry, Diagnostic and Biomedical Sciences, Research Office, 7500 Cambridge Street, room 4334, Houston, TX 77054 USA
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Structure, function, and productivity from the National Dental Practice-Based Research Network. J Clin Transl Sci 2022; 6:e87. [PMID: 35989860 PMCID: PMC9379935 DOI: 10.1017/cts.2022.421] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 06/14/2022] [Accepted: 06/16/2022] [Indexed: 11/06/2022] Open
Abstract
Abstract
Introduction:
Following inception in 2005 as a multiregional practice-based research network (PBRN), the “National Dental PBRN” expanded nationwide in 2012, and in 2019 implemented additional organizational changes. The objectives are to: (1) describe the new structure and function of the network; and (2) quantify its scientific productivity since 2005.
Methods:
A national Administrative and Resource Center is based in Alabama; regional and specialty nodes are based in Alabama, Florida, Illinois, Minnesota, Oregon, New York, and Texas. A Network Coordinating Center is based in Oregon. Studies are funded via investigator-initiated grants. Scientific productivity is assessed using specific metrics, including the Relative Citation Ratio.
Results:
To date, 58 studies have been completed or are in data collection or development. These studies have investigated a broad range of topics using a wide variety of study designs. Of the studies that have completed enrollment, 70,665 patients were enrolled, as were 19,827 practitioners (some participated in multiple studies), plus electronic records for 790,493 patients in two data-only studies. To date, these studies have led to 193 peer-reviewed scientific publications in 62 different journals. The mean (1.40) Relative Citation Ratio of Network publications connotes a greater-than-average influence in their fields.
Conclusions:
These metrics demonstrate that the PBRN research context can successfully engage practitioners and patients from diverse settings nationally with a high and sustained level of scientific productivity. This infrastructure has enabled clinical scientists in oral health and nonoral health topics and provided additional recruitment venues outside of the typical academic health center research context.
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Canceill T, Monsarrat P, Faure-Clement E, Tohme M, Vergnes JN, Grosgogeat B. Dental practice-based research networks (D-PBRN) worldwide: A scoping review. J Dent 2020; 104:103523. [PMID: 33186627 DOI: 10.1016/j.jdent.2020.103523] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 11/02/2020] [Accepted: 11/05/2020] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES For more than twenty years, dental practice-based research networks (D-PBRN) have helped to structure clinical research in private practice. They bring together practitioners working in several structures and may include a greater number of subjects. The aims of this study were thus to systematically explore the scientific production from dental private practices in general and to map and describe the D-PBRN activity worldwide. DATA SOURCES Two research procedures were carried out in parallel. The first was conducted as a scoping review to examine peer-reviewed literature indexed in the PubMed database and the second was performed on the World Wide Web to identify the main characteristics of the networks (location, scientific production…). STUDY SELECTION 368 publications were identified among which 202 were published by PBRN members and the others by private practitioners not affiliated to any network. 210 (57 % of the included articles) were produced in the USA. A higher number of diverse centers are involved in each study when it is conducted by a PBRN (59.06 ± 66.59 vs. 13.51 ± 31.58 for networks and independent teams, respectively; p < 0.01). 24 D-PBRN were identified, a majority being based in the USA and 8 in Europe. CONCLUSIONS Although dental practice-based research has grown over the years, the number of D-PBRN worldwide remains low. Even if it requires some investment to produce research in dental offices, this type of networks helps to fill the gap between private practice and research and to improve knowledge on oral health. RELEVANCE The mapping of all the dental PBRN together with the research topics studied throughout the world make the relevance of this article. The ways to improve practice-based research in dentistry are also discussed in the paper.
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Affiliation(s)
- Thibault Canceill
- Université Paul Sabatier, Faculté de Chirurgie Dentaire, Hôpitaux de Toulouse, 3 Chemin des Maraîchers, Toulouse Cedex 9, 31062, France; CIRIMAT, University of Toulouse, CNRS, INPT, Université Paul Sabatier, Faculté de Pharmacie, 35 Chemin des Maraichers, Toulouse cedex 9, 31062, France.
| | - Paul Monsarrat
- Université Paul Sabatier, Faculté de Chirurgie Dentaire, Hôpitaux de Toulouse, 3 Chemin des Maraîchers, Toulouse Cedex 9, 31062, France; Toulouse Institute of Artificial Intelligence ANITI, Toulouse, France; STROMALab, Université de Toulouse, CNRS ERL 5311, EFS, ENVT, Inserm, UPS, France
| | - Edouard Faure-Clement
- Université Lyon 1, Faculté d'Odontologie, 11 rue Guillaume Paradin, Lyon, 69008, France; Hospices Civils de Lyon, Pôle d'Odontologie, 6-8 place Deperet, Lyon, 69007, France
| | - Marie Tohme
- Université Lyon 1, Faculté d'Odontologie, 11 rue Guillaume Paradin, Lyon, 69008, France; Hospices Civils de Lyon, Pôle d'Odontologie, 6-8 place Deperet, Lyon, 69007, France
| | - Jean-Noël Vergnes
- Université Paul Sabatier, Faculté de Chirurgie Dentaire, Hôpitaux de Toulouse, 3 Chemin des Maraîchers, Toulouse Cedex 9, 31062, France; Division of Oral Health and Society, Faculty of dentistry, McGill University, Montreal, Quebec, Canada
| | - Brigitte Grosgogeat
- Université Lyon 1, Faculté d'Odontologie, 11 rue Guillaume Paradin, Lyon, 69008, France; Hospices Civils de Lyon, Pôle d'Odontologie, 6-8 place Deperet, Lyon, 69007, France; Université Lyon 1, LMI UMR CNRS 5615, 11 rue Guillaume Paradin, Lyon, 69008, France
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McCracken MS, Litaker MS, Thomson AES, Slootsky A, Gilbert GH. Laboratory Technician Assessment of the Quality of Single-Unit Crown Preparations and Impressions as Predictors of the Clinical Acceptability of Crowns as Determined by the Treating Dentist: Findings from the National Dental Practice-Based Research Network. J Prosthodont 2020; 29:114-123. [PMID: 31893566 DOI: 10.1111/jopr.13137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/18/2019] [Indexed: 11/29/2022] Open
Abstract
PURPOSE In-laboratory assessment by laboratory technicians may offer insight to increase clinical success of dental crowns, and research in this area is lacking. MATERIALS AND METHODS Dentists in the National Dental Practice-Based Research Network enrolled patients in a study about single-unit crowns; laboratory technicians evaluated the quality of tooth preparations and impressions. The primary outcome for each crown was clinical acceptability (CAC), as judged by the treating dentist. A secondary outcome was "Goodness of Fit (GOF)," a composite score of several aspects of clinical fit, also judged by the study dentist. A mixed-effects logistic regression was used to analyze associations between laboratory technician ratings and the CAC and GOF. RESULTS Dentists (n = 205) evaluated 3731 crowns. Technicians ranked the marginal detail of impressions as good or excellent in 92% of cases; other aspects of the impression were ranked good or excellent 88% of the time. Regarding tooth preparation, about 90% of preparations were considered adequate (neither excessive nor inadequate reduction). Factors associated with higher CAC were more preparation taper, and use of optical imaging. Factors associated with better GOF were higher impression quality, greater occlusal reduction, more preparation taper, and optical imaging. CONCLUSIONS Overall quality of preparations and impressions was very high, as evaluated by laboratory technicians. Several clinical parameters were associated with higher CAC and GOF. Clinicians who struggle with crown remakes might consider less conservative tooth preparation, as well as using digital impression technology.
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Affiliation(s)
- Michael S McCracken
- Department of Clinical and Community Sciences, School of Dentistry, University of Alabama at Birmingham, Birmingham, AL
| | - Mark S Litaker
- Department of Clinical and Community Sciences, School of Dentistry, University of Alabama at Birmingham, Birmingham, AL
| | | | - Alan Slootsky
- Department of Prosthodontics, Nova Southeastern University, College of Dental Medicine, Davie, FL.,Private Practice of Dentistry, Pompano Beach, FL
| | - Gregg H Gilbert
- Department of Clinical and Community Sciences, School of Dentistry, University of Alabama at Birmingham, Birmingham, AL
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Ullah R, Adnan S, Afzal AS. Top-Cited Articles from Dental Education Journals, 2009 to 2018: A Bibliometric Analysis. J Dent Educ 2019; 83:1382-1391. [PMID: 31501253 DOI: 10.21815/jde.019.153] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 07/22/2019] [Indexed: 12/29/2022]
Abstract
The number of citations an article receives is an important indicator to quantify its influence in its field. The aim of this study was to identify and analyze the characteristics of the 50 top-cited articles addressing dental education published in two journals dedicated to dental education (European Journal of Dental Education and Journal of Dental Education). The Web of Science database was searched to retrieve the 50 most-cited articles from the two journals in December 2018. The top-cited articles were analyzed for journal of publication, number of citations, institution and country of origin, year of publication, study type, keywords, theme and subtheme, and international collaborations. The results showed the 50 top-cited articles were cited between 24 and 146 times each. The majority of these top-cited articles (n=34) were published in the Journal of Dental Education Half (n=25) of the articles were by authors in the U.S. The most common study types were surveys (n=26) and reviews (n=10). The main themes of these top-cited articles were curriculum and learner characteristics. This bibliometric analysis can serve as a reference for recognizing studies with the most impact in the scholarship of dental education.
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Affiliation(s)
- Rizwan Ullah
- Rizwan Ullah, BDS, MSc, is Assistant Professor, Department of Oral Biology, Sindh Institute of Oral Health Sciences, Jinnah Sindh Medical University, Karachi, Pakistan; Samira Adnan, BDS, FCPS, is Assistant Professor, Department of Operative Dentistry, Sindh Institute of Oral Health Sciences, Jinnah Sindh Medical University, Karachi, Pakistan; and Azam S. Afzal, MBBS, MHPE, is Senior Instructor, Department for Educational Development, Aga Khan University, Karachi, Pakistan.
| | - Samira Adnan
- Rizwan Ullah, BDS, MSc, is Assistant Professor, Department of Oral Biology, Sindh Institute of Oral Health Sciences, Jinnah Sindh Medical University, Karachi, Pakistan; Samira Adnan, BDS, FCPS, is Assistant Professor, Department of Operative Dentistry, Sindh Institute of Oral Health Sciences, Jinnah Sindh Medical University, Karachi, Pakistan; and Azam S. Afzal, MBBS, MHPE, is Senior Instructor, Department for Educational Development, Aga Khan University, Karachi, Pakistan
| | - Azam S Afzal
- Rizwan Ullah, BDS, MSc, is Assistant Professor, Department of Oral Biology, Sindh Institute of Oral Health Sciences, Jinnah Sindh Medical University, Karachi, Pakistan; Samira Adnan, BDS, FCPS, is Assistant Professor, Department of Operative Dentistry, Sindh Institute of Oral Health Sciences, Jinnah Sindh Medical University, Karachi, Pakistan; and Azam S. Afzal, MBBS, MHPE, is Senior Instructor, Department for Educational Development, Aga Khan University, Karachi, Pakistan
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Rotzenberg K, Chui MA. Improving Recruitment and Retention of Pharmacists in a Practice-Based Research Network. PHARMACY 2019; 7:E131. [PMID: 31487896 PMCID: PMC6789795 DOI: 10.3390/pharmacy7030131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 08/23/2019] [Accepted: 08/30/2019] [Indexed: 11/24/2022] Open
Abstract
Pharmacy practice-based research networks (PBRNs) are relatively new compared to their primary care forebears, representing a unique set of research challenges. Recruitment and retention of network members are essential to maintaining the integrity of the network and achieving its research goals. Many studies have evaluated recruitment and retention of practitioners to individual studies, while far fewer have reported on recruitment and retention to the network itself. This literature review summarizes current practices for PBRN member recruitment and retention from a pharmacy perspective.
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Affiliation(s)
- Katherine Rotzenberg
- Social & Administrative Sciences Division, University of Wisconsin-Madison School of Pharmacy and the Sonderegger Research Center for Improved Medication Outcomes, Pharmacy Practice Enhancement and Action Research Link (PearlRx) PBRN, Madison, WI 53705, USA.
| | - Michelle A Chui
- Social & Administrative Sciences Division, University of Wisconsin-Madison School of Pharmacy and the Sonderegger Research Center for Improved Medication Outcomes, Pharmacy Practice Enhancement and Action Research Link (PearlRx) PBRN, Madison, WI 53705, USA.
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Psoter WJ, Morse DE, Kerr AR, Tomar SL, Aguilar ML, Harris DR, Stone LH, Makhija SK, Kaste LM, Strumwasser B, Pihlstrom DJ, Masterson EE, Meyerowitz C. Oral cancer examinations and lesion discovery as reported by U.S. general dentists: Findings from the National Dental Practice-Based Research Network. Prev Med 2019; 124:117-123. [PMID: 31122615 PMCID: PMC6540813 DOI: 10.1016/j.ypmed.2019.03.034] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 03/11/2019] [Accepted: 03/17/2019] [Indexed: 12/17/2022]
Abstract
General dentists (GDs) have the opportunity to examine their patients for oral premalignancy/malignancy. We estimated the annualized per dentist number of oral lesions suspicious for premalignancy/malignancy discovered by United States (U.S.) general dentists and the annualized per dentist number of histologically-confirmed cancers subsequently diagnosed. Eligible participants were licensed, clinically-active U.S. GDs who were members of the U.S. National Dental Practice-Based Research Network. An a priori sample size of 900 was determined; 2000 GDs were invited to participate; 1,073 completed the study. Self-reported, cross-sectional data were obtained via an online questionnaire during 4/12/2017-8/31/2017 and analyzed. The reported numbers of suspicious oral lesions and histologically-confirmed oral cancer cases diagnosed over the previous six months were quantified. Potential outcome predictors were evaluated as covariates in multivariable analyses. Crude and adjusted statistics were produced by regressing each outcome on each independent variable while assuming a Poisson distribution, log link and utilizing robust standard errors. Eighty-seven percent of dentists reported discovering 1+ lesion suspicious for oral premalignancy/malignancy during the preceding six months. The mean number of suspicious lesions/dentist/year was 9.5; adjusted mean: 9.6. Fifteen percent of participants reported discovering 1+ lesion confirmed as cancer during the same period, 213 confirmed cancer cases/6 months or 426/year. Crude and adjusted mean numbers of histologically-confirmed oral cancers were both 0.4 cancers/dentist/year. Our findings suggest that many U.S. general dentists are actively identifying oral lesions suspicious for premalignancy/malignancy, thereby aiding in the discovery of oral malignancies and representing an important component in the frontline against cancer.
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Affiliation(s)
- Walter J Psoter
- Eastman Institute for Oral Health, University of Rochester School of Medicine and Dentistry, 601 Elmwood Ave, Rochester, NY 14620, United States of America.
| | - Douglas E Morse
- Eastman Institute for Oral Health, University of Rochester School of Medicine and Dentistry, United States of America.
| | - Alexander Ross Kerr
- Department of Oral & Maxillofacial Pathology, Radiology & Medicine, New York University College of Dentistry, United States of America.
| | - Scott L Tomar
- University of Florida College of Dentistry, Department of Community Dentistry and Behavioral Science, United States of America.
| | - Maria L Aguilar
- Department of Restorative Dental Science, Division of Prosthodontics, University of Florida College of Dentistry, United States of America.
| | | | | | - Sonia K Makhija
- Department of Clinical and Community Sciences, Division of Behavioral and Population Sciences, University of Alabama at Birmingham, United States of America.
| | - Linda M Kaste
- Department of Pediatric Dentistry, University of Illinois College of Dentistry, United States of America.
| | | | | | - Erin E Masterson
- Department of Oral Health Sciences, University of Washington, United States of America.
| | - Cyril Meyerowitz
- Eastman Institute for Oral Health, University of Rochester School of Medicine and Dentistry, United States of America.
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Minyé HM, Gilbert GH, Litaker MS, Mungia R, Meyerowitz C, Louis DR, Slootsky A, Gordan VV, McCracken MS. Preparation Techniques Used to Make Single-Unit Crowns: Findings from The National Dental Practice-Based Research Network. J Prosthodont 2018; 27:813-820. [PMID: 30311319 PMCID: PMC6283672 DOI: 10.1111/jopr.12988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2018] [Indexed: 12/01/2022] Open
Abstract
PURPOSE To: (1) determine which preparation techniques clinicians use in routine clinical practice for single-unit crown restorations; (2) test whether certain practice, dentist, and patient characteristics are significantly associated with these techniques. MATERIALS AND METHODS Dentists in the National Dental Practice-Based Research Network participated in a questionnaire regarding preparation techniques, dental equipment used for single-unit crown preparations, scheduled chair time, occlusal clearance determination, location of finish lines, magnification during preparation, supplemental lighting, shade selection, use of intraoral photographs, and trimming dies. Survey responses were compared by dentist and practice characteristics using ANOVA. RESULTS Of the 2132 eligible dentists, 1777 (83%) responded to the survey. The top two margin configuration choices for single-unit crown preparation for posterior crowns were chamfer/heavy chamfer (65%) and shoulder (23%). For anterior crowns, the most prevalent choices were the chamfer (54%) and the shoulder (37%) configurations. Regarding shade selection, a combination of dentist, assistant, and patient input was used to select anterior shades 59% of the time. Photographs are used to communicate shade selection with the laboratory in about half of esthetically demanding cases. The ideal finish line was located at the crest of gingival tissue for 49% of respondents; 29% preferred 1 mm below the crest; and 22% preferred the finish line above the crest of tissue. Average chair time scheduled for a crown preparation appointment was 76 ± 21 minutes. Practice and dentist characteristics were significantly associated with margin choice including practice type (p < 0.001), region (p < 0.001), and years since graduation (p < 0.001). CONCLUSIONS Network dentists prefer chamfer/heavy chamfer margin designs, followed by shoulder preparations. These choices were related to practice and dentist characteristics.
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Affiliation(s)
- Helena M Minyé
- Private practice of general dentistry, Odessa and Fort Worth, TX
| | - Gregg H Gilbert
- Department of Clinical and Community Sciences, School of Dentistry, University of Alabama at Birmingham, Birmingham, AL
| | - Mark S Litaker
- Department of Clinical and Community Sciences, School of Dentistry, University of Alabama at Birmingham, Birmingham, AL
| | - Rahma Mungia
- Department of Periodontics University of Texas Health Science Center at San Antonio, San Antonio, TX
| | - Cyril Meyerowitz
- Eastman Institute for Oral Health, University of Rochester, Rochester, NY
| | - David R Louis
- Private practice of general dentistry with HealthPartners, Woodbury, MN
| | - Alan Slootsky
- Private practice of general dentistry, Pompano Beach, FL
| | - Valeria V Gordan
- Restorative Dental Sciences Department, Operative Dentistry Division, College of Dentistry, University of Florida, Gainesville, FL
| | - Michael S McCracken
- Department of Clinical and Community Sciences, School of Dentistry, University of Alabama at Birmingham, Birmingham, AL
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McCracken MS, Litaker MS, Gordan VV, Karr T, Sowell E, Gilbert GH. Remake Rates for Single-Unit Crowns in Clinical Practice: Findings from The National Dental Practice-Based Research Network. J Prosthodont 2018; 28:122-130. [PMID: 30412320 DOI: 10.1111/jopr.12995] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2018] [Indexed: 11/28/2022] Open
Abstract
PURPOSE Some crowns returned from the laboratory are clinically unacceptable, and dentists must remake them. The objectives of this study were to: (1) quantify the remake rate of single-unit crowns; and (2) identify factors significantly associated with crown remakes and intraoral fit. MATERIALS AND METHODS Dentists participating in the National Dental Practice-Based Research Network recruited patients needing crowns and documented fabrication techniques, patient characteristics, and outcomes. Crowns were considered clinically acceptable or rejected. Also, various aspects of the clinical fit of the crown were graded and categorized as 'Goodness of Fit (GOF).' Dentist and patient characteristics were tested statistically for associations with crown acceptability and GOF. RESULTS More than 200 dentists participated in this study (N = 205) and evaluated 3750 single-unit crowns. The mean age (years) of patients receiving a crown was 55. The remake rate for crowns was 3.8%. The range of rejection rates among individual practitioners was 0% to 42%. Most clinicians (118, or 58%) did not reject any crowns; all rejections came from 42% of the clinicians (n = 87). The most common reasons for rejections were proximal misfit, marginal errors, and esthetic failures. Fewer years in practice was significantly associated with lower crown success rates and lower fit scores. GOF was also associated with practice busyness and patient insurance status, patient gender (dentists reported better fit for female patients), and patient ethnicity. CONCLUSIONS The crown remake rate in this study was about 4%. Remakes and crown GOF were associated with certain dentist and practice characteristics.
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Affiliation(s)
- Michael S McCracken
- Department of Clinical and Community Sciences, School of Dentistry, University of Alabama at Birmingham, Birmingham, AL
| | - Mark S Litaker
- Department of Clinical and Community Sciences, School of Dentistry, University of Alabama at Birmingham, Birmingham, AL
| | - Valeria V Gordan
- Restorative Dental Sciences Department, Operative Dentistry Division, College of Dentistry, University of Florida, Gainesville, FL
| | | | - Ellen Sowell
- Department of Clinical and Community Sciences, School of Dentistry, University of Alabama at Birmingham, Birmingham, AL
| | - Gregg H Gilbert
- Department of Clinical and Community Sciences, School of Dentistry, University of Alabama at Birmingham, Birmingham, AL
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McCauley JL, Gilbert GH, Cochran DL, Gordan VV, Leite RS, Fillingim RB, Brady KT. Prescription Drug Monitoring Program Use: National Dental PBRN Results. JDR Clin Trans Res 2018; 4:178-186. [PMID: 30931705 DOI: 10.1177/2380084418808517] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION The American Dental Association recommends that dentists use a prescription drug monitoring program (PDMP) prior to prescribing an opioid for acute pain management. OBJECTIVE The objective of this study was to examine dentists' experiences using their state PDMP, as well as the impact that state-mandated registration policies, mandated use policies, and practice characteristics had on the frequency with which dentists used their PDMP. METHODS We conducted a web-based cross-sectional survey among practicing dentist members of the National Dental Practice-Based Research Network ( n = 805). The survey assessed prescribing practices for pain management and implementation of risk mitigation strategies, including PDMP use. Survey data were linked with network Enrollment Questionnaire data to include practitioner demographics and practice characteristics. RESULTS Nearly half of respondents ( n = 375, 46.6%) reported having never accessed a PDMP, with the most common reasons for nonaccess being lack of awareness ( n = 214, 57.1%) and lack of knowledge regarding registration and use ( n = 94, 25.1%). The majority of PDMP users reported the program to be very helpful (58.1%) or somewhat helpful (31.6%). Dentists reported that PDMP use most often did not change their intended prescribing behavior (40.2%), led them not to prescribe an opioid (33.5%), or led them to prescribe fewer opioid doses (25.5%). Presence of a mandated use policy was significantly associated with increased frequency of PDMP use across a variety of situations, including prior to 1) prescribing any opioid for pain management, 2) issuing refills, 3) prescribing to new patients, and 4) prescribing to patients deemed high risk. CONCLUSION Findings suggest that the majority of dentists find PDMPs helpful in informing their opioid-prescribing practices. Whereas the existence of a state-mandated use policy is a consistent predictor of dentists' PDMP use, outreach and education efforts may overcome key barriers to use identified in this study. KNOWLEDGE TRANSFER STATEMENT Findings from this national survey suggest that the majority of practicing dentists find PDMPs helpful in informing their opioid-prescribing practices; however, consistent PDMP use was not common. Whereas the existence of a state-mandated use policy is a consistent predictor of dentists' PDMP use, outreach and education efforts may overcome key barriers to use identified in this study.
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Affiliation(s)
- J L McCauley
- 1 Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - G H Gilbert
- 2 Department of Clinical and Community Sciences, University of Alabama at Birmingham, Birmingham, USA
| | - D L Cochran
- 3 Department of Periodontics, UT Health San Antonio, San Antonio, USA
| | - V V Gordan
- 4 Department of Restorative Dental Sciences, University of Florida, Gainesville, FL, USA
| | - R S Leite
- 5 Department of Stomatology, Medical University of South Carolina, Charleston, SC, USA
| | - R B Fillingim
- 6 Department of Restorative Dental Sciences, University of Florida, USA
| | - K T Brady
- 1 Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA.,7 Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, USA
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- 8 National Dental PBRN Collaborative Group, which includes practitioner, faculty, and staff investigators who contributed to this activity ( http://nationaldentalpbrn.org/collaborative-group.php )
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12
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Morténius H, Twetman S. Creating research and development awareness among dental care professionals by use of strategic communication: a 12-year intervention study. BMC Oral Health 2017; 17:164. [PMID: 29284480 PMCID: PMC5747106 DOI: 10.1186/s12903-017-0445-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 12/07/2017] [Indexed: 11/19/2022] Open
Abstract
Background Despite the availability of contemporary research advances, only a limited fraction is implemented into dental practice. One possible way to facilitate this process is to stimulate the research and development (R&D) awareness and interest with aid of strategic communication. Methods The aim of the study was to analyse the role of a strategic communication in R&D awareness and interest among dental care professionals (DCP) over a 12-year period. A second aim was to compare the findings with those from primary care professionals (PCP). The project had a prospective design and the intervention was conducted through established oral, written and digital channels. The outcome was captured by two validated questionnaires submitted after 7 and 12 years, respectively. An additional Questionnaire file shows the details [see Additional file 1]. The material consisted of 599 health care professionals (205 DCP; 394 PCP) that responded to the first questionnaire and 526 individuals (195 DCP; 331 PCP) who responded to the second. All were employed by the primary care organization of Region Halland located in southwest of Sweden. The majority were women (≥ 85%) and the mean age at the first questionnaire was 49 years (SD 8.5). Longitudinal analyses were applied to those individuals that responded to both surveys after 7 and 12 years (n = 248). Comparisons between DCP’s and PCP’s were processed with Chi-square and Fischer’s exact tests. Results Strategic communication contributed to increase the R&D awareness and interest among the dental personnel. The created interest was reported stronger among the DCP when compared with PCP at both surveys (p < 0.05). The longitudinal findings confirmed a long-term interest among the DCP’s. Direct and indirect communication facilitated R&D interest in both groups. The most powerful channels were the written “Research bulletin” and peer inspiration. Conclusion Strategic communication can be employed as a scientific tool that may contribute to the creation of a long-term R&D awareness and interest among dental care professionals. Electronic supplementary material The online version of this article (10.1186/s12903-017-0445-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Helena Morténius
- Department of Research and Development, Region Halland, Hospital of Halland, Halmstad, SE-301 85, Halmstad, Sweden. .,Department of Primary Health Care, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - Svante Twetman
- Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Makhija SK, Robinson ME, Bader JD, Shugars DA, Litaker MS, Im HR, Rindal DB, Pihlstrom DJ, Meyerowitz C, Gordan VV, Buchberg MK, Gilbert GH. Dentists' decision strategies for suspicious occlusal caries lesions in a National Dental PBRN study. J Dent 2017; 69:83-87. [PMID: 29138112 DOI: 10.1016/j.jdent.2017.11.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 10/25/2017] [Accepted: 11/08/2017] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE Case presentations (vignettes) were completed by dentists in the National Dental Practice-Based Research Network study "Decision Aids for the Management of Suspicious Occlusal Caries Lesions (SOCLs)". The objective was to determine dentists' decision strategies for SOCLs. METHODS 107 dentists viewed a series of 16 vignettes that represented all combinations of 4 clinical cues: color, luster, lesion roughness, and patient-level caries risk. Each vignette included a patient description and a photograph of a tooth presenting the 4 cues. Dentists were asked to decide the likelihood that a suspected lesion extended into dentin. A lens model analysis was used to examine how dentists use these cues in making their decisions. RESULTS 86% of dentists had a consistent pattern of cue use that defined their decision strategy. On average, 70% of the variance in their decisions was accounted for by their use of the 4 cues. However, there was considerable variability in the individual cues used by each dentist. The percentages of dentists who used the different cues consistently were: luster (58%), color (48%), roughness (36%), and risk (35%). 14% of dentists reliably used only color, 7% used only luster, 4% used only roughness, and 1% used only risk when making SOCL decisions. CONCLUSIONS The online vignette system suggests that clinical SOCL decision strategies are highly individualized and dentists do not use all cues available to them to make these decisions. CLINICAL SIGNIFICANCE Prior to this study, there has been little evidence about how dentists use these cues (either individually or in combination) when judging the extent of caries progression. Such knowledge would be valuable when designing interventions to help dentists maximize the likelihood of appropriate treatment decisions.
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Affiliation(s)
- Sonia K Makhija
- University of Alabama at Birmingham, Birmingham, AL, United States.
| | | | - James D Bader
- University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Daniel A Shugars
- University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Mark S Litaker
- University of Alabama at Birmingham, Birmingham, AL, United States
| | - Hong R Im
- Private Practice, Austin, TX, United States
| | - D Brad Rindal
- HealthPartners Institute, Minneapolis, MN, United States
| | | | - Cyril Meyerowitz
- University of Rochester, Eastman Institute for Oral Health, Rochester, NY, United States
| | | | - Meredith K Buchberg
- University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Gregg H Gilbert
- University of Alabama at Birmingham, Birmingham, AL, United States
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14
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McCracken MS, Louis DR, Litaker MS, Minyé HM, Oates T, Gordan VV, Marshall DG, Meyerowitz C, Gilbert GH. Impression Techniques Used for Single-Unit Crowns: Findings from the National Dental Practice-Based Research Network. J Prosthodont 2017; 27:722-732. [PMID: 28076661 DOI: 10.1111/jopr.12577] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2016] [Indexed: 12/01/2022] Open
Abstract
PURPOSE To: (1) determine which impression and gingival displacement techniques practitioners use for single-unit crowns on natural teeth; and (2) test whether certain dentist and practice characteristics are significantly associated with the use of these techniques. MATERIALS AND METHODS Dentists participating in the National Dental Practice-Based Research Network were eligible for this survey study. The study used a questionnaire developed by clinicians, statisticians, laboratory technicians, and survey experts. The questionnaire was pretested via cognitive interviewing with a regionally diverse group of practitioners. The survey included questions regarding gingival displacement and impression techniques. Survey responses were compared by dentist and practice characteristics using ANOVA. RESULTS The response rate was 1777 of 2132 eligible dentists (83%). Regarding gingival displacement, most clinicians reported using either a single cord (35%) or dual cord (35%) technique. About 16% of respondents preferred an injectable retraction technique. For making impressions, the most frequently used techniques and materials are: poly(vinyl siloxane), 77%; polyether, 12%; optical/digital, 9%. A dental auxiliary or assistant made the final impression 2% of the time. Regarding dual-arch impression trays, 23% of practitioners report they typically use a metal frame tray, 60% use a plastic frame, and 16% do not use a dual-arch tray. Clinicians using optical impression techniques were more likely to be private practice owners or associates. CONCLUSIONS This study documents current techniques for gingival displacement and making impressions for crowns. Certain dentist and practice characteristics are significantly associated with these techniques.
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Affiliation(s)
- Michael S McCracken
- Department of Clinical and Community Sciences, School of Dentistry, University of Alabama at Birmingham, Birmingham, AL
| | - David R Louis
- Private practice of general dentistry with HealthPartners, Woodbury, MN
| | - Mark S Litaker
- Department of Clinical and Community Sciences, School of Dentistry, University of Alabama at Birmingham, Birmingham, AL
| | - Helena M Minyé
- Private practice of general dentistry, Odessa and Fort Worth, TX
| | - Thomas Oates
- School of Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX
| | - Valeria V Gordan
- Restorative Dental Sciences Department, Operative Dentistry Division, College of Dentistry, University of Florida, Gainesville, FL
| | | | - Cyril Meyerowitz
- Eastman Institute for Oral Health, University of Rochester, Rochester, NY
| | - Gregg H Gilbert
- Department of Clinical and Community Sciences, School of Dentistry, University of Alabama at Birmingham, Birmingham, AL
| | -
- The National Dental PBRN Collaborative Group includes practitioner, faculty, and staff investigators who contributed to this activity
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15
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Dember LM, Archdeacon P, Krishnan M, Lacson E, Ling SM, Roy-Chaudhury P, Smith KA, Flessner MF. Pragmatic Trials in Maintenance Dialysis: Perspectives from the Kidney Health Initiative. J Am Soc Nephrol 2016; 27:2955-2963. [PMID: 27401689 PMCID: PMC5042681 DOI: 10.1681/asn.2016030340] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Pragmatic clinical trials are conducted under the real-world conditions of clinical care delivery. As a result, these trials yield findings that are highly generalizable to the nonresearch setting, identify interventions that are readily translatable into clinical practice, and cost less than trials that require extensive research infrastructures. Maintenance dialysis is a setting especially well suited for pragmatic trials because of inherently frequent and predictable patient encounters, highly granular and uniform data collection, use of electronic data systems, and delivery of care by a small number of provider organizations to approximately 90% of patients nationally. Recognizing the potential for pragmatic trials to generate much needed evidence to guide the care of patients receiving maintenance dialysis, the Kidney Health Initiative assembled a group of individuals with relevant expertise from academia, industry, and government to provide the nephrology community with information about the design and conduct of such trials, with a specific focus on the dialysis setting. Here, we review this information, and where applicable, use experience from the ongoing Time to Reduce Mortality in End Stage Renal Disease Trial, a large cluster-randomized, pragmatic trial evaluating hemodialysis session duration, to illustrate challenges and solutions to operational, ethical, and regulatory issues.
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Affiliation(s)
- Laura M Dember
- Renal, Electrolyte and Hypertension Division and Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania;
| | - Patrick Archdeacon
- Office of Medical Policy and Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland
| | | | - Eduardo Lacson
- Nephrology Division, Tufts Medical Center and Tufts University School of Medicine, Boston, Massachusetts
| | - Shari M Ling
- Center for Clinical Standards and Quality, Centers for Medicare and Medicaid Services, Baltimore, Maryland
| | - Prabir Roy-Chaudhury
- Division of Nephrology, The University of Arizona College of Medicine and Southern Arizona Veterans Administration Health Care System, Tucson, Arizona
| | - Kimberly A Smith
- Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland
| | - Michael F Flessner
- Division of Kidney, Urology, and Hematology, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland
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16
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Establishing the ACORN National Practitioner Database: Strategies to Recruit Practitioners to a National Practice-Based Research Network. J Manipulative Physiol Ther 2016; 39:594-602. [DOI: 10.1016/j.jmpt.2016.08.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Revised: 08/19/2016] [Accepted: 08/19/2016] [Indexed: 11/20/2022]
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17
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Funkhouser E, Vellala K, Baltuck C, Cacciato R, Durand E, McEdward D, Sowell E, Theisen SE, Gilbert GH. Survey Methods to Optimize Response Rate in the National Dental Practice-Based Research Network. Eval Health Prof 2016; 40:332-358. [PMID: 26755526 DOI: 10.1177/0163278715625738] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Surveys of health professionals typically have low response rates, and these rates have been decreasing in the recent years. We report on the methods used in a successful survey of dentist members of the National Dental Practice-Based Research Network. The objectives were to quantify the (1) increase in response rate associated with successive survey methods, (2) time to completion with each successive step, (3) contribution from the final method and personal contact, and (4) differences in response rate and mode of response by practice/practitioner characteristics. Dentist members of the network were mailed an invitation describing the study. Subsequently, up to six recruitment steps were followed: initial e-mail, two e-mail reminders at 2-week intervals, a third e-mail reminder with postal mailing a paper questionnaire, a second postal mailing of paper questionnaire, and staff follow-up. Of the 1,876 invited, 160 were deemed ineligible and 1,488 (87% of 1,716 eligible) completed the survey. Completion by step: initial e-mail, 35%; second e-mail, 15%; third e-mail, 7%; fourth e-mail/first paper, 11%; second paper, 15%; and staff follow-up, 16%. Overall, 76% completed the survey online and 24% on paper. Completion rates increased in absolute numbers and proportionally with later methods of recruitment. Participation rates varied little by practice/practitioner characteristics. Completion on paper was more likely by older dentists. Multiple methods of recruitment resulted in a high participation rate: Each step and method produced incremental increases with the final step producing the largest increase.
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Affiliation(s)
| | | | | | | | - Emily Durand
- 5 HealthPartners Institute for Education and Research, Minneapolis, MN, USA
| | - Deborah McEdward
- 6 College of Dentistry, University of Florida, Gainesville, FL, USA
| | - Ellen Sowell
- 1 University of Alabama at Birmingham, Birmingham, AL, USA
| | - Sarah E Theisen
- 7 University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
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- 1 University of Alabama at Birmingham, Birmingham, AL, USA
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Gilbert GH, Riley JL, Eleazer PD, Benjamin PL, Funkhouser E. Discordance between presumed standard of care and actual clinical practice: the example of rubber dam use during root canal treatment in the National Dental Practice-Based Research Network. BMJ Open 2015; 5:e009779. [PMID: 26656026 PMCID: PMC4679916 DOI: 10.1136/bmjopen-2015-009779] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES Use of a rubber dam during root canal treatment is considered the standard of care because it enhances patient safety and optimises the odds of successful treatment. Nonetheless, not all dentists use a rubber dam, creating disconnect between presumed standard of care and what is actually done in clinical practice. Little is known about dentists' attitudes towards use of the rubber dam in their practices. The objectives were to: (1) quantify these attitudes and (2) test the hypothesis that specific attitudes are significantly associated with rubber dam use. SETTING National Dental Practice-Based Research Network (NationalDentalPBRN.org). PARTICIPANTS 1490 network dentists. OUTCOME MEASURES Dentists completed a questionnaire about their attitudes towards rubber dam use during root canal treatment. Three attitude scales comprised 33 items that used a 5-point ordinal scale to measure beliefs about effectiveness, inconvenience, ease of placement, comparison to other isolation techniques and patient factors. Factor analysis, cluster analysis and multivariable logistic regression analysed the relationship between attitudes and rubber dam use. RESULTS All items had responses at each point on the 5-point scale, with an overall pattern of substantial variation across dentists. Five attitudinal factors (rubber dam effectiveness; inconvenient/time-consuming; ease of placement; effectiveness compared to Isolite; patient factors) and 4 clusters of practitioners were identified. Each factor and cluster was independently and strongly associated with rubber dam use. CONCLUSIONS General dentists have substantial variation in attitudes about rubber dam use. Beliefs that rubber dam use is not effective, inconvenient, time-consuming, not easy to place or affected by patient factors, were independently and significantly associated with lower rubber dam use. These attitudes explain why there is substantial discordance between presumed standard of care and actual practice.
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Affiliation(s)
- Gregg H Gilbert
- Department of Clinical and Community Sciences, School of Dentistry, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Joseph L Riley
- Department of Community Dentistry and Behavioral Science, College of Dentistry, University of Florida, Gainesville, Florida, USA
| | - Paul D Eleazer
- Department of Endodontics, School of Dentistry, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | | | - Ellen Funkhouser
- Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
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Livingood WC, Peden AH, Shah GH, Marshall NA, Gonzalez KM, Toal RB, Alexander DS, Wright AR, Woodhouse LD. Comparison of practice based research network based quality improvement technical assistance and evaluation to other ongoing quality improvement efforts for changes in agency culture. BMC Health Serv Res 2015; 15:300. [PMID: 26227958 PMCID: PMC4521478 DOI: 10.1186/s12913-015-0956-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Accepted: 07/14/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Public health agencies in the USA are increasingly challenged to adopt Quality Improvement (QI) strategies to enhance performance. Many of the functional and structural barriers to effective use of QI can be found in the organizational culture of public health agencies. The purpose of this study was to assess the impact of public health practice based research network (PBRN) evaluation and technical assistance for QI interventions on the organizational culture of public health agencies in Georgia, USA. METHODS An online survey of key informants in Georgia's districts and county health departments was used to compare perceptions of characteristics of organizational QI culture between PBRN supported QI districts and non-PBRN supported districts before and after the QI interventions. The primary outcomes of concern were number and percentage of reported increases in characteristics of QI culture as measured by key informant responses to items assessing organizational QI practices from a validated instrument on QI Collaboratives. Survey results were analyzed using Multi-level Mixed Effects Logistic Model, which accounts for clustering/nesting. RESULTS Increases in QI organizational culture were consistent for all 10- items on a QI organizational culture survey related to: leadership support, use of data, on-going QI, and team collaboration. Statistically significant odds ratios were calculated for differences in increased QI organizational culture between PBRN-QI supported districts compared to Non-PBRN supported districts for 5 of the 10 items, after adjusting for District clustering of county health departments. CONCLUSIONS Agency culture, considered by many QI experts as the main goal of QI, is different than use of specific QI methods, such as Plan-Do-Study-Act (PDSA) cycles or root-cause analyses. The specific use of a QI method does not necessarily reflect culture change. Attempts to measure QI culture are newly emerging. This study documented significant improvements in characteristics of organizational culture and demonstrated the potential of PBRNs to support agency QI activities.
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Affiliation(s)
- William C Livingood
- Center for Health Equity & Quality Research, University of Florida College of Medicine-Jacksonville, 580 West 8th St, Tower II, Suite 6015, Jacksonville, FL, 32082, USA.
| | - Angela H Peden
- Jiann Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA.
| | - Gulzar H Shah
- Jiann Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA.
| | - Nandi A Marshall
- Department of Health Sciences, Armstrong State University, Savannah, GA, USA.
| | - Ketty M Gonzalez
- East Central Health District (retired), District 6, Augusta, GA, USA
| | - Russell B Toal
- Jiann Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA.
| | - Dayna S Alexander
- Division of Pharmaceutical Outcomes & Policy, UNC Eshelman School of Pharmacy, Asheville, NC, USA.
| | - Alesha R Wright
- Jiann Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA.
| | - Lynn D Woodhouse
- Center for Health Equity & Quality Research, University of Florida College of Medicine-Jacksonville, 580 West 8th St, Tower II, Suite 6015, Jacksonville, FL, 32082, USA.
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20
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Practical considerations for conducting dental clinical trials in primary care. Br Dent J 2015; 218:629-34. [DOI: 10.1038/sj.bdj.2015.498] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2015] [Indexed: 11/08/2022]
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21
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Lawson NC, Gilbert GH, Funkhouser E, Eleazer PD, Benjamin PL, Worley DC. General Dentists' Use of Isolation Techniques during Root Canal Treatment: From the National Dental Practice-based Research Network. J Endod 2015; 41:1219-25. [PMID: 26015159 DOI: 10.1016/j.joen.2015.04.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Revised: 03/24/2015] [Accepted: 04/19/2015] [Indexed: 11/16/2022]
Abstract
INTRODUCTION A preliminary study done by a National Dental Practice-Based Research Network precursor observed that 44% of general dentists (GDs) reported always using a rubber dam (RD) during root canal treatment (RCT). This full-scale study quantified the use of all isolation techniques, including RD use. METHODS Network practitioners completed a questionnaire about isolation techniques used during RCT. Network enrollment questionnaire data provided practitioner characteristics. RESULTS One thousand four hundred ninety of 1716 eligible GDs participated (87%); 697 (47%) reported always using an RD. This percentage varied by tooth type. These GDs were more likely to always use an RD, do not own a private practice, perform less than 10 RCTs/month, and have postgraduate training. CONCLUSIONS Most GDs do not use an RD all the time. Ironically, RDs are used more frequently by GDs who do not perform molar RCT. RD use varies with tooth type and certain dentist, practice, and patient characteristics.
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Affiliation(s)
- Nathaniel C Lawson
- Department of Clinical and Community Sciences, School of Dentistry, University of Alabama at Birmingham, Birmingham, Alabama
| | - Gregg H Gilbert
- Department of Clinical and Community Sciences, School of Dentistry, University of Alabama at Birmingham, Birmingham, Alabama.
| | - Ellen Funkhouser
- Division of Preventive Medicine, Department of Medicine, School of Dentistry, University of Alabama at Birmingham, Birmingham, Alabama
| | - Paul D Eleazer
- Department of Endodontics, School of Dentistry, University of Alabama at Birmingham, Birmingham, Alabama
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HPV vaccination not linked to multiple sclerosis. Br Dent J 2015. [DOI: 10.1038/sj.bdj.2015.397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Adams J, Steel A, Chang S, Sibbritt D. Helping address the national research and research capacity needs of Australian chiropractic: introducing the Australian Chiropractic Research Network (ACORN) project. Chiropr Man Therap 2015; 23:12. [PMID: 25834727 PMCID: PMC4381492 DOI: 10.1186/s12998-015-0057-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Accepted: 02/03/2015] [Indexed: 11/10/2022] Open
Abstract
Chiropractic is a popular health care choice in Australia and yet major gaps in our empirical understanding of this area of practice remain. Furthermore, while some research excellence exists, a largely uncoordinated approach to research activity and development has in effect led to silos of interest and a lack of strategic ‘big-picture’ planning essential to producing a sustainable research culture and capacity for the profession. This commentary identifies the significance of a number of key features - including a national, coordinated focus, and a rich engagement with the practitioner and patient base amongst others – arguably important to the future development of research and research capacity within Australian chiropractic. The design features and phases of the Australian Chiropractic Research Network (ACORN) project are also outlined. ACORN is one contemporary initiative specifically developed to address chiropractic’s research and research capacity building needs and help grow a broad evidence-base to inform safe, effective patient care.
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Affiliation(s)
- Jon Adams
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology, Sydney, Australia
| | - Amie Steel
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology, Sydney, Australia ; Office of Research, Endeavour College of Natural Health, Brisbane, Australia
| | - Sungwon Chang
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology, Sydney, Australia
| | - David Sibbritt
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology, Sydney, Australia
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Gilbert GH, Gordan VV, Korelitz JJ, Fellows JL, Meyerowitz C, Oates TW, Rindal DB, Gregory RJ. Provision of specific dental procedures by general dentists in the National Dental Practice-Based Research Network: questionnaire findings. BMC Oral Health 2015; 15:11. [PMID: 25608862 PMCID: PMC4324862 DOI: 10.1186/1472-6831-15-11] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2014] [Accepted: 01/14/2015] [Indexed: 12/22/2022] Open
Abstract
Background Objectives were to: (1) determine whether and how often general dentists (GDs) provide specific dental procedures; and (2) test the hypothesis that provision is associated with key dentist, practice, and patient characteristics. Methods GDs (n = 2,367) in the United States National Dental Practice-Based Research Network completed an Enrollment Questionnaire that included: (1) dentist; (2) practice; and (3) patient characteristics, and how commonly they provide each of 10 dental procedures. We determined how commonly procedures were provided and tested the hypothesis that provision was substantively related to the three sets of characteristics. Results Two procedure categories were classified as “uncommon” (orthodontics, periodontal surgery), three were “common” (molar endodontics; implants; non-surgical periodontics), and five were “very common” (restorative; esthetic procedures; extractions; removable prosthetics; non-molar endodontics). Dentist, practice, and patient characteristics were substantively related to procedure provision; several characteristics seemed to have pervasive effects, such as dentist gender, training after dental school, full-time/part-time status, private practice vs. institutional practice, presence of a specialist in the same practice, and insurance status of patients. Conclusions As a group, GDs provide a comprehensive range of procedures. However, provision by individual dentists is substantively related to certain dentist, practice, and patient characteristics. A large number and broad range of factors seem to influence which procedures GDs provide. This may have implications for how GDs respond to the ever-changing landscape of dental care utilization, patient population demography, scope of practice, delivery models and GDs’ evolving role in primary care. Electronic supplementary material The online version of this article (doi:10.1186/1472-6831-15-11) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Gregg H Gilbert
- Department of Clinical and Community Sciences, School of Dentistry, University of Alabama at Birmingham, SDB Room 109, 1530 Third Avenue South, Birmingham, AL 35294-0007, USA.
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SARKIS-ONOFRE R, PEREIRA-CENCI T, OPDAM NJ, DEMARCO FF. Preference for using posts to restore endodontically treated teeth: findings from a survey with dentists. Braz Oral Res 2014; 29:1-6. [DOI: 10.1590/1807-3107bor-2015.vol29.0001] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Accepted: 08/02/2014] [Indexed: 11/21/2022] Open
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Nalliah RP, Lee MK, Da Silva JD, Allareddy V. Impact of a Research Requirement in a Dental School Curriculum. J Dent Educ 2014. [DOI: 10.1002/j.0022-0337.2014.78.10.tb05809.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Romesh P. Nalliah
- Office of Global and Community Health and Office of Dental Education; Harvard School of Dental Medicine
| | - Min Kyeong Lee
- Department of Developmental Biology; Harvard School of Dental Medicine
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Solomon S, Eakin B, Kirk R, Piechowski P, Thomas B. Piloting a nationally disseminated, interactive human subjects protection program for community partners: design, content, and evaluation. Clin Transl Sci 2014; 7:177-83. [PMID: 24720288 DOI: 10.1111/cts.12154] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Funders, institutions, and research organizations are increasingly recognizing the need for human subjects protections training programs for those engaged in academic research. Current programs tend to be online and directed toward an audience of academic researchers. Research teams now include many nonacademic members, such as community partners, who are less likely to respond to either the method or the content of current online trainings. A team at the CTSA-supported Michigan Institute for Clinical and Health Research at the University of Michigan developed a pilot human subjects protection training program for community partners that is both locally implemented and adaptable to local contexts, yet nationally consistent and deliverable from a central administrative source. Here, the developers and the analysts of this program discuss its development, its content, and the results of its evaluation.
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Affiliation(s)
- Stephanie Solomon
- Albert Gnaegi Center for Health Care Ethics, Saint Louis University, Saint Louis, Missouri, USA
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Electronic dental record use and clinical information management patterns among practitioner-investigators in The Dental Practice-Based Research Network. J Am Dent Assoc 2013; 144:49-58. [PMID: 23283926 DOI: 10.14219/jada.archive.2013.0013] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND The growing availability of electronic data offers practitioners increased opportunities for reusing clinical data for research and quality improvement. However, relatively little is known about what clinical data practitioners keep on their computers regarding patients. METHODS The authors conducted a web-based survey of 991 U.S. and Scandinavian practitioner-investigators (P-Is) in The Dental Practice-Based Research Network to determine the extent of their use of computers to manage clinical information; the type of patient information they kept on paper, a computer or both; and their willingness to reuse electronic dental record (EDR) data for research. RESULTS A total of 729 (73.6 percent) of 991 P-Is responded.A total of 73.8 percent of U.S. solo practitioners and 78.7 percent of group practitioners used a computer to manage some patient information, and 14.3 percent and 15.9 percent, respectively, managed all patient information on a computer. U.S. practitioners stored appointments, treatment plans, completed treatment and images electronically most frequently, and the periodontal charting, diagnosis, medical history, progress notes and the chief complaint least frequently.More than 90 percent of Scandinavian practitioners stored all information electronically.A total of 50.8 percent of all P-Is were willing to reuse EDR data for research, and 63.1 percent preferred electronic forms for data collection. CONCLUSION The results of this study show that the trend toward increased adoption of EDRs in the United States is continuing, potentially making more data in electronic form available for research. Participants appear to be willing to reuse EDR data for research and to collect data electronically. CLINICAL IMPLICATIONS The rising rates of EDR adoption may offer increased opportunities for reusing electronic data for quality improvement and research.
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Liu K, Acharya A, Alai S, Schleyer TK. Using electronic dental record data for research: a data-mapping study. J Dent Res 2013; 92:90S-6S. [PMID: 23690362 PMCID: PMC3706179 DOI: 10.1177/0022034513487560] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Anecdotal evidence suggests that, during the clinical care process, many dental practices record some data that are also collected in dental practice based research network (PBRN) studies. Since the use of existing, electronically stored data for research has multiple benefits, we investigated the overlap between research data fields used in dental PBRN studies and clinical data fields typically found in general dental records. We mapped 734 unique data elements from the Dental Information Model (DIM) to 2,487 Common Data Elements (CDE) curated by the NIDCR's PBRNs in the Cancer Data Standards Registry and Repository (caDSR). Thirty-three percent of the DIM data elements matched at least one CDE completely and 9% partially, translating to about 9% and 2%, respectively, of all data elements used in PBRN studies. The most frequently used CDEs found in the DIM included data about dental anatomy, medications, and items such as oral biopsy and caries. Our study shows that a non-trivial number of data elements in general dental records can be mapped either completely or partially to data fields in research studies. Further studies should investigate the feasibility of electronic clinical data for research purposes.
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Affiliation(s)
- K Liu
- Center for Dental Informatics, Department of Dental Public Health, University of Pittsburgh School of Dental Medicine, Pittsburgh, PA 15261, USA.
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Heaven TJ, Gordan VV, Litaker MS, Fellows JL, Brad Rindal D, Firestone AR, Gilbert GH. Agreement among dentists' restorative treatment planning thresholds for primary occlusal caries, primary proximal caries, and existing restorations: findings from The National Dental Practice-Based Research Network. J Dent 2013; 41:718-25. [PMID: 23743181 DOI: 10.1016/j.jdent.2013.05.014] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Revised: 05/23/2013] [Accepted: 05/26/2013] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES The aim of this study was to quantify the agreement among individual National Dental Practice-Based Research Network dentists' self-reported treatment decisions for primary occlusal caries, primary proximal caries, and existing restorations. METHODS Five hypothetical clinical scenarios were presented: primary occlusal caries; primary proximal caries; and whether three existing restorations should be repaired or replaced. We quantified the probability that dentists who recommended later restorative intervention for primary caries were the same ones who recommended that existing restorations be repaired instead of replaced. RESULTS Dentists who recommended later restorative treatment of primary occlusal caries and proximal caries at a more-advanced stage were significantly more likely to recommend repair instead of replacement. Agreement among dentists on a threshold stage for the treatment of primary caries ranged from 40 to 68%, while that for repair or replacement of existing restorations was 36 to 43%. CONCLUSIONS Dentists who recommended repair rather than replacement of existing restorations were significantly more likely to recommend later treatment of primary caries. Conversely, dentists who recommended treatment of primary caries at an earlier stage were significantly more likely to recommend replacement of the entire restoration. Between-dentist agreement for primary caries treatment was better than between-dentist agreement for repair or replacement of existing restorations. CLINICAL IMPLICATIONS These findings suggest consistency in how individual dentists approach the treatment of primary caries and existing restorations. However, substantial variation was found between dentists in their treatment decisions about the same teeth.
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Affiliation(s)
- Tim J Heaven
- University of Alabama at Birmingham, Department of Restorative Sciences, 1919 7th Avenue South, AL 35294-0007, United States.
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Blue CM, Funkhouser DE, Riggs S, Rindal DB, Worley D, Pihlstrom DJ, Benjamin P, Gilbert GH. Utilization of nondentist providers and attitudes toward new provider models: findings from the National Dental Practice-Based Research Network. J Public Health Dent 2013; 73:237-44. [PMID: 23668892 DOI: 10.1111/jphd.12020] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2012] [Accepted: 04/07/2013] [Indexed: 12/01/2022]
Abstract
OBJECTIVES The purpose of this study was to quantify, within the National Dental Practice-Based Research Network, current utilization of dental hygienists and assistants with expanded functions and quantify network dentists' attitudes toward a new nondentist provider model - the dental therapist. METHODS National Dental Practice-Based Research Network practitioner-investigators participated in a single, cross-sectional administration of a questionnaire. RESULTS Current nondentist providers are not being utilized by network practitioner-investigators to the fullest extent allowed by law. Minnesota practitioners, practitioners in large group practices, and those with prior experience with expanded-function nondentist providers delegate at a higher rate and had more-positive perceptions of the new dental therapist model. CONCLUSIONS Expanding scopes of practice for dental hygienists and assistants has not translated to the maximal delegation allowed by law among network practices. This finding may provide insight into dentists' acceptance of newer nondentist provider models.
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Affiliation(s)
- Christine M Blue
- Department of Primary Dental Care, University of Minnesota, Minneapolis, MN, USA
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Gilbert GH, Williams OD, Korelitz JJ, Fellows JL, Gordan VV, Makhija SK, Meyerowitz C, Oates TW, Rindal DB, Benjamin PL, Foy PJ. Purpose, structure, and function of the United States National Dental Practice-Based Research Network. J Dent 2013; 41:1051-9. [PMID: 23597500 DOI: 10.1016/j.jdent.2013.04.002] [Citation(s) in RCA: 106] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2013] [Revised: 04/03/2013] [Accepted: 04/05/2013] [Indexed: 10/27/2022] Open
Abstract
OBJECTIVE Following a successful 2005-2012 phase with three regional practice-based research networks (PBRNs), a single, unified national network called "The National Dental PBRN" was created in 2012 in the United States to improve oral health by conducting practice-based research and serving dental professionals through education and collegiality. METHODS Central administration is based in Alabama. Regional centres are based in Alabama, Florida, Minnesota, Oregon, New York and Texas, with a Coordinating Centre in Maryland. Ideas for studies are prioritized by the Executive Committee, comprised mostly of full-time clinicians. RESULTS To date, 2763 persons have enrolled, from all six network regions; enrollment continues to expand. They represent a broad range of practitioners, practice types, and patient populations. Practitioners are actively improving every step of the research process, from idea generation, to study development, field testing, data collection, and presentation and publication. CONCLUSIONS Practitioners from diverse settings are partnering with fellow practitioners and academics to improve clinical practice and meet the needs of clinicians and their patients. CLINICAL SIGNIFICANCE This "nation's network" aims to serve as a precious national resource to improve the scientific basis for clinical decision-making and foster movement of the latest evidence into routine practice.
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Affiliation(s)
- Gregg H Gilbert
- Department of Clinical and Community Sciences, School of Dentistry, University of Alabama at Birmingham, Birmingham, AL, United States.
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Gordan VV. Translating research into everyday clinical practice: lessons learned from a USA dental practice-based research network. Dent Mater 2013; 29:3-9. [PMID: 22889478 PMCID: PMC3524332 DOI: 10.1016/j.dental.2012.07.159] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2012] [Revised: 07/24/2012] [Accepted: 07/27/2012] [Indexed: 02/05/2023]
Abstract
OBJECTIVES This paper discusses practice-based research (PBR) as a means to speed up the translation of research findings to clinical practice. It also reviews repair versus replacement of defective restorations as one example of the delay in the application of research findings to clinical practice. METHODS Despite the existence of clinical studies, a significant delay exists between the generation of new knowledge and its application into the medical/dental community and their patients. One example is the repair of defective dental restorations. About 75% of practitioners in general dental practices do not consider the repair of dental restorations as a viable alternative to the replacement of defective restorations. Engaging and partnering with health practitioners in the field on studies addressing everyday clinical research questions may offer a solution to speed up the translation of the research findings. RESULTS Practice-based research (PBR) offers a unique opportunity for practitioners to be involved in the research process, formulating clinical research questions. Additionally, PBR generates evidence-based knowledge with a broader spectrum that can be more readily generalized to the public. With PBR, clinicians are involved in the entire research process from its inception to its dissemination. SIGNIFICANCE Early practitioner interaction in the research process may result in ideas being more readily incorporated into practice. Clinical studies are of paramount importance for testing and translation of the research findings to the community.
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Affiliation(s)
- Valeria V Gordan
- Department of Restorative Dental Sciences, University of Florida, Gainesville, FL, USA.
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Gilbert GH, Gordan VV, Funkhouser EM, Rindal DB, Fellows JL, Qvist V, Anderson G, Worley D. Caries treatment in a dental practice-based research network: movement toward stated evidence-based treatment. Community Dent Oral Epidemiol 2012; 41:143-53. [PMID: 23036131 DOI: 10.1111/cdoe.12008] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2012] [Accepted: 08/23/2012] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Practice-based research networks (PBRNs) provide a venue to foster evidence-based care. We tested the hypothesis that a higher level of participation in a dental PBRN is associated with greater stated change toward evidence-based practice. METHODS A total of 565 dental PBRN practitioner-investigators completed a baseline questionnaire entitled 'Assessment of Caries Diagnosis and Treatment'; 405 of these also completed a follow-up questionnaire about treatment of caries and existing restorations. Certain questions (six treatment scenarios) were repeated at follow-up a mean (SD) of 36.0 (3.8) months later. A total of 224 were 'full participants' (enrolled in clinical studies and attended at least one network meeting); 181 were 'partial participants' (did not meet 'full' criteria). RESULTS From 10% to 62% of practitioners were 'surgically invasive' at baseline, depending on the clinical scenario. Stated treatment approach was significantly less invasive at follow-up for four of six items. Change was greater among full participants and those with a more-invasive approach at baseline, with an overall pattern of movement away from the extremes. CONCLUSIONS These results are consistent with a preliminary conclusion that network participation fostered movement of scientific evidence into routine practice. PBRNs may foster movement of evidence into everyday practice as practitioners become engaged in the scientific process.
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Affiliation(s)
- Gregg H Gilbert
- Department of Clinical and Community Sciences, School of Dentistry, University of Alabama at Birmingham, Birmingham, AL 35294-0007, USA.
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Botello-Harbaum MT, Demko CA, Curro FA, Rindal DB, Collie D, Gilbert GH, Hilton TJ, Craig RG, Wu J, Funkhouser E, Lehman M, McBride R, Thompson V, Lindblad A. Information-Seeking Behaviors of Dental Practitioners in Three Practice-Based Research Networks. J Dent Educ 2012. [DOI: 10.1002/j.0022-0337.2013.77.2.tb05457.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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