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Baqai HS, Zaidi SJA, Baig QA, Bashir MB, Anwar M, Ansari AS. Maintenance of dental records and awareness of forensic odontology among pakistani dentists: a mixed-method study with implications for dental data repository. BMC Oral Health 2023; 23:783. [PMID: 37875855 PMCID: PMC10594786 DOI: 10.1186/s12903-023-03500-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 10/06/2023] [Indexed: 10/26/2023] Open
Abstract
OBJECTIVE Dental records and forensic odontology play an important role in both healthcare and the legal system, aiding in personalized patient care, human identification, and legal proceedings. This study aims to investigate dental record-keeping practices and assess the awareness of forensic odontology among Pakistani dentists over 12 months. This study aims to collect data from 500 dentists, identify areas for enhancement, and develop a strategic action plan to improve record-keeping quality and forensic odontology application, culminating in a comprehensive dental data repository to support legal and criminal investigations in Pakistan. METHODOLOGY This study employed a mixed-method approach conducted at Hamdard Dental College from January to March 2023. The quantitative phase involved distributing questionnaires to 463 dentists, chosen through stratified random sampling. Out of these, 413 responded, yielding an 86% response rate. These questionnaires focused on dental record-keeping practices and dentists' awareness of forensic odontology. Subsequently, based on the questionnaire results, face-to-face interviews were conducted with 20 purposively selected dentists to gain deeper insight into the challenges and potential solutions. Data from both phases were integrated and analyzed accordingly. RESULTS The study included 413 participants, mainly females (79%), with ages ranging from 27 to 65 years and an average age of 46.4 years. Most dentists had 5-20 years of work experience (53%), and most (87.4%) were practicing in private clinical settings. All the dentists generated medical and dental records, but the duration of their record-keeping varied, with some maintaining them for up to a year and others for two years or longer. Five themes were generated from the qualitative content analysis. These themes were dentists' perceptions, barriers and challenges, knowledge and awareness, and improvement strategies. CONCLUSION Our study revealed that local practitioners in Pakistan exhibit subpar practices in dental record-keeping and maintenance of patient history, irrespective of whether they use a digital or traditional file-based system. Even though dentists are cognizant of the importance of record-keeping, they do not actively maintain comprehensive records. This suggests the need for improved training and system improvements to address the gaps in record-keeping practices.
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Affiliation(s)
- Haifa Saquib Baqai
- Department of Oral Biology, Hamdard Dental College, Hamdard University, Karachi, Pakistan
| | - Syed Jaffar Abbas Zaidi
- Department of Oral Biology, Dow Dental College, Dow University of Health Sciences, Karachi, Sindh, 74200, Pakistan.
| | - Qaiser Ali Baig
- Department of Community Dentistry, Dow International Dental College, Dow University of Health Sciences, Karachi, Pakistan
| | | | - Madiha Anwar
- Department of Oral Biology, Bahria University Medical & Dental College, Karachi, Pakistan
| | - Asma Saher Ansari
- Department of Oral Biology, Dr Ishrat ul Ebad Khan Institute of Oral Health Sciences, Dow University of Health Sciences, Karachi, Pakistan
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Muralidharan S, Pendyala G, Gandhage D, Sachan S. Knowledge of Dental Ethics and Jurisprudence Among Dental Practitioners in Pune: A Questionnaire Survey. Cureus 2022; 14:e31503. [DOI: 10.7759/cureus.31503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2022] [Indexed: 11/16/2022] Open
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Jacquemard T, Doherty CP, Fitzsimons MB. The anatomy of electronic patient record ethics: a framework to guide design, development, implementation, and use. BMC Med Ethics 2021; 22:9. [PMID: 33541335 PMCID: PMC7859903 DOI: 10.1186/s12910-021-00574-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 01/12/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND This manuscript presents a framework to guide the identification and assessment of ethical opportunities and challenges associated with electronic patient records (EPR). The framework is intended to support designers, software engineers, health service managers, and end-users to realise a responsible, robust and reliable EPR-enabled healthcare system that delivers safe, quality assured, value conscious care. METHODS Development of the EPR applied ethics framework was preceded by a scoping review which mapped the literature related to the ethics of EPR technology. The underlying assumption behind the framework presented in this manuscript is that ethical values can inform all stages of the EPR-lifecycle from design, through development, implementation, and practical application. RESULTS The framework is divided into two parts: context and core functions. The first part 'context' entails clarifying: the purpose(s) within which the EPR exists or will exist; the interested parties and their relationships; and the regulatory, codes of professional conduct and organisational policy frame of reference. Understanding the context is required before addressing the second part of the framework which focuses on EPR 'core functions' of data collection, data access, and digitally-enabled healthcare. CONCLUSIONS The primary objective of the EPR Applied Ethics Framework is to help identify and create value and benefits rather than to merely prevent risks. It should therefore be used to steer an EPR project to success rather than be seen as a set of inhibitory rules. The framework is adaptable to a wide range of EPR categories and can cater for new and evolving EPR-enabled healthcare priorities. It is therefore an iterative tool that should be revisited as new EPR-related state-of-affairs, capabilities or activities emerge.
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Affiliation(s)
- Tim Jacquemard
- FutureNeuro, the SFI Research Centre for Chronic and Rare Neurological Diseases, RCSI, 123 Stephen’s Green, Dublin 2, Ireland
| | - Colin P. Doherty
- FutureNeuro, the SFI Research Centre for Chronic and Rare Neurological Diseases, RCSI, 123 Stephen’s Green, Dublin 2, Ireland
- St. James’s Hospital, James’s Street, Dublin 8, Ireland
- Trinity College Dublin, Dublin 2, College Green, Ireland
| | - Mary B. Fitzsimons
- FutureNeuro, the SFI Research Centre for Chronic and Rare Neurological Diseases, RCSI, 123 Stephen’s Green, Dublin 2, Ireland
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Jacquemard T, Doherty CP, Fitzsimons MB. Examination and diagnosis of electronic patient records and their associated ethics: a scoping literature review. BMC Med Ethics 2020; 21:76. [PMID: 32831076 PMCID: PMC7446190 DOI: 10.1186/s12910-020-00514-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 08/03/2020] [Indexed: 02/22/2023] Open
Abstract
Background Electronic patient record (EPR) technology is a key enabler for improvements to healthcare service and management. To ensure these improvements and the means to achieve them are socially and ethically desirable, careful consideration of the ethical implications of EPRs is indicated. The purpose of this scoping review was to map the literature related to the ethics of EPR technology. The literature review was conducted to catalogue the prevalent ethical terms, to describe the associated ethical challenges and opportunities, and to identify the actors involved. By doing so, it aimed to support the future development of ethics guidance in the EPR domain. Methods To identify journal articles debating the ethics of EPRs, Scopus, Web of Science, and PubMed academic databases were queried and yielded 123 eligible articles. The following inclusion criteria were applied: articles need to be in the English language; present normative arguments and not solely empirical research; include an abstract for software analysis; and discuss EPR technology. Results The medical specialty, type of information captured and stored in EPRs, their use and functionality varied widely across the included articles. Ethical terms extracted were categorised into clusters ‘privacy’, ‘autonomy’, ‘risk/benefit’, ‘human relationships’, and ‘responsibility’. The literature shows that EPR-related ethical concerns can have both positive and negative implications, and that a wide variety of actors with rights and/or responsibilities regarding the safe and ethical adoption of the technology are involved. Conclusions While there is considerable consensus in the literature regarding EPR-related ethical principles, some of the associated challenges and opportunities remain underdiscussed. For example, much of the debate is presented in a manner more in keeping with a traditional model of healthcare and fails to take account of the multidimensional ensemble of factors at play in the EPR era and the consequent need to redefine/modify ethical norms to align with a digitally-enabled health service. Similarly, the academic discussion focuses predominantly on bioethical values. However, approaches from digital ethics may also be helpful to identify and deliberate about current and emerging EPR-related ethical concerns.
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Affiliation(s)
- Tim Jacquemard
- FutureNeuro, the SFI Research Centre for Chronic and Rare Neurological Diseases, 123 Stephen's Green, Dublin 2, Ireland.
| | - Colin P Doherty
- FutureNeuro, the SFI Research Centre for Chronic and Rare Neurological Diseases, 123 Stephen's Green, Dublin 2, Ireland.,Department of Neurology, St. James's Hospital, James's Street, Dublin 8, Ireland.,Trinity College Dublin, College Green, Dublin 2, Ireland
| | - Mary B Fitzsimons
- FutureNeuro, the SFI Research Centre for Chronic and Rare Neurological Diseases, 123 Stephen's Green, Dublin 2, Ireland
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Favaretto M, Shaw D, De Clercq E, Joda T, Elger BS. Big Data and Digitalization in Dentistry: A Systematic Review of the Ethical Issues. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E2495. [PMID: 32268509 PMCID: PMC7177351 DOI: 10.3390/ijerph17072495] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 04/03/2020] [Accepted: 04/04/2020] [Indexed: 12/19/2022]
Abstract
Big Data and Internet and Communication Technologies (ICT) are being increasingly implemented in the healthcare sector. Similarly, research in the field of dental medicine is exploring the potential beneficial uses of digital data both for dental practice and in research. As digitalization is raising numerous novel and unpredictable ethical challenges in the biomedical context, our purpose in this study is to map the debate on the currently discussed ethical issues in digital dentistry through a systematic review of the literature. Four databases (Web of Science, Pub Med, Scopus, and Cinahl) were systematically searched. The study results highlight how most of the issues discussed by the retrieved literature are in line with the ethical challenges that digital technologies are introducing in healthcare such as privacy, anonymity, security, and informed consent. In addition, image forgery aimed at scientific misconduct and insurance fraud was frequently reported, together with issues of online professionalism and commercial interests sought through digital means.
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Affiliation(s)
- Maddalena Favaretto
- Institute for Biomedical Ethics, University of Basel, 4056 Basel, Switzerland; (D.S.); (E.D.C.); (B.S.E.)
| | - David Shaw
- Institute for Biomedical Ethics, University of Basel, 4056 Basel, Switzerland; (D.S.); (E.D.C.); (B.S.E.)
| | - Eva De Clercq
- Institute for Biomedical Ethics, University of Basel, 4056 Basel, Switzerland; (D.S.); (E.D.C.); (B.S.E.)
| | - Tim Joda
- Department of Reconstructive Dentistry, University Center for Dental Medicine Basel, 4058 Basel, Switzerland;
| | - Bernice Simone Elger
- Institute for Biomedical Ethics, University of Basel, 4056 Basel, Switzerland; (D.S.); (E.D.C.); (B.S.E.)
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Drozdova OV. [Problems of education in foreign university dental clinics]. STOMATOLOGIIA 2018; 97:82-86. [PMID: 30199075 DOI: 10.17116/stomat20189704182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- O V Drozdova
- Moscow State Medical and Dental University, Moscow, Russia
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Valenza JA, Taylor D, Walji MF, Johnson CW. Assessing the Benefit of a Personalized EHR-Generated Informed Consent in a Dental School Setting. J Dent Educ 2014. [DOI: 10.1002/j.0022-0337.2014.78.8.tb05790.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- John A. Valenza
- Department of General Practice and Dental Public Health; The University of Texas School of Dentistry at Houston
| | - David Taylor
- Department of Diagnostic and Biomedical Sciences; The University of Texas School of Dentistry at Houston
| | - Muhammad F. Walji
- Department of Diagnostic and Biomedical Sciences and Associate Dean; Technology Services and Informatics; The University of Texas School of Dentistry at Houston
| | - Craig W. Johnson
- The University of Texas School of Biomedical Informatics at Houston
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Armitage GC. Learned and unlearned concepts in periodontal diagnostics: a 50-year perspective. Periodontol 2000 2014; 62:20-36. [PMID: 23574462 DOI: 10.1111/prd.12006] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
In the past 50 years, conceptual changes in the field of periodontal diagnostics have paralleled those associated with a better scientific understanding of the full spectrum of processes that affect periodontal health and disease. Fifty years ago, concepts regarding the diagnosis of periodontal diseases followed the classical pathology paradigm. It was believed that the two basic forms of destructive periodontal disease were chronic inflammatory periodontitis and 'periodontosis'- a degenerative condition. In the subsequent 25 years it was shown that periodontosis was an infection. By 1987, major new concepts regarding the diagnosis and pathogenesis of periodontitis included: (i) all cases of untreated gingivitis do not inevitably progress to periodontitis; (ii) progression of untreated periodontitis is often episodic; (iii) some sites with untreated periodontitis do not progress; (iv) a rather small population of specific bacteria ('periodontal pathogens') appear to be the main etiologic agents of chronic inflammatory periodontitis; and (v) tissue damage in periodontitis is primarily caused by inflammatory and immunologic host responses to infecting agents. The concepts that were in place by 1987 are still largely intact in 2012. However, in the decades to come, it is likely that new information on the human microbiome will change our current concepts concerning the prevention, diagnosis and treatment of periodontal diseases.
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Suebnukarn S, Rittipakorn P, Thongyoi B, Boonpitak K, Wongsapai M, Pakdeesan P. Usability assessment of an electronic health record in a comprehensive dental clinic. SPRINGERPLUS 2013; 2:220. [PMID: 23741651 PMCID: PMC3667354 DOI: 10.1186/2193-1801-2-220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Accepted: 04/30/2013] [Indexed: 11/22/2022]
Abstract
In this paper we present the development and usability of an electronic health record (EHR) system in a comprehensive dental clinic.The graphic user interface of the system was designed to consider the concept of cognitive ergonomics.The cognitive task analysis was used to evaluate the user interface of the EHR by identifying all sub-tasks and classifying them into mental or physical operators, and to predict task execution time required to perform the given task. We randomly selected 30 cases that had oral examinations for routine clinical care in a comprehensive dental clinic. The results were based on the analysis of 4 prototypical tasks performed by ten EHR users. The results showed that on average a user needed to go through 27 steps to complete all tasks for one case. To perform all 4 tasks of 30 cases, they spent about 91 min (independent of system response time) for data entry, of which 51.8 min were spent on more effortful mental operators. In conclusion, the user interface can be improved by reducing the percentage of mental effort required for the tasks.
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