How meta-analytic evidence impacts clinical decision making in oral implantology: a Delphi opinion poll

Trends in the level of evidence and impact of clinical studies published in leading oral implantology journals: 2008-2018

OBJECTIVES

To present the characteristics and level of evidence (LOE) of clinical studies published in leading oral implantology journals during 2008-2018 and to explore whether the LOE of a study is associated with its scientific and social impact.

MATERIALS AND METHODS

Clinical studies with direct relevance to the evaluation of healthcare interventions published in 2008, 2013, and 2018 in six oral implantology journals were identified via hand searches. A modified 4-level Oxford 2011 LOE tool was used to assess the LOE of all eligible studies. The citation count and Altmetric Attention Score (AAS) of each study were extracted from Web of Science and Altmetric Explorer, respectively. Thereafter, multivariable generalized estimation equation analyses were used to investigate the association between LOE, citation counts, and AAS, adjusting for potential confounding factors and clustering effects.

RESULTS

A total of 763 clinical studies were included, among which the proportion of level-1, level-2, level-3, and level-4 studies was 2.4%, 30.4%, 40.2%, and 27.0%, respectively. During 2008-2018, the proportion of high LOE studies (level-1 and level-2) increased substantially from 24.6% to 43.1%, although the number of systematic reviews that only include randomized controlled trials has remained limited. According to multivariable analyses, the citation count (p = .002) and AAS (p = .005) of high LOE studies were both significantly greater than those of low LOE studies.

CONCLUSIONS

During the past decade, the proportion of high LOE studies has increased substantially in the field of oral implantology. Clinical studies with higher LOE tend to have greater scientific and social impact.

Preferences and flexibility in decision-making among dental clinicians regarding the treatment of multirooted teeth: an interactive communication device-based survey at two academic conferences

Purpose

Decision-making by dental and medical experts can be influenced by their biases, interests, and experiences, and academic arguments about controversial issues may additionally be considered indirect experiences capable of affecting decision-making. This study reports on the use of interactive communication devices to evaluate preferences and flexibility in decision-making among dental care providers who attended two distinct academic conferences.

Methods

Two debates were presented by a team of two lecturers at two academic conferences (focusing on periodontology and implant dentistry, respectively) and the audience members of each session were surveyed. Before each lecture, two case modules about the diagnosis and treatment of multirooted molar lesions were provided, and interactive communication devices were used to collect responses about decision-making preferences in treatment planning immediately before and after a debate about treatment strategies.

Results

In total, 81 and 84 completed answers from both conferences were obtained for the first and second case modules, respectively. The preferred treatment plan differed significantly according to the focus of the conference, and a tendency emerged for the clinicians participating in each conference to express uniform preferences. However, attending the debates resulted in significant changes in decision-making preferences regardless of the conference focus or the characteristics of the participants.

Conclusions

Our findings suggest that providing continuing education via debates on controversial issues may be effective in widening conceptual knowledge and reducing biases among experts in the dental and medical fields.