DPHS 535

Scientific Literature in Clinical Decision Making

Philippe Hujoel

1 Credit / Quarter 11 (Spring, Third Year)

Course Description

Clinical decisions related to diagnosis, etiology, therapy, and prognosis can be challenging. When can one tell a patient that “reliable evidence” exists that a clinical intervention will cause an improvement in the patient condition? This course provides an introduction to the principles underlying an evidence-based approach to clinical decisions and starts with an overview of the 5 different levels of evidence. Additional topics related to reliability of clinical decisions include the formulation of a PICO question, temporality, data torturing, the formulation of a research question, refutation, placebo effects, and scientific conflicts of interest.

Educational Objectives

To provide students with the ability to independently assess the scientific evidence of reports and make evidence-based decisions on diagnosis, etiology, treatment, and prognosis.

Course Outline

Levels of evidence and uncertainty

  • The evidence-pyramid: the foundation of an evidence-based clinical practice
  • The dental and medical disasters that continue to shape the evidence pyramid
  • Levels of evidence and its impact on dentistry
  • How much evidence is enough?

Etiology and Harm: What causes dental diseases?

  • Epidemiology versus biological plausibility
  • Epidemiology and its limitations
  • Epidemiology of cancer and heart disease; how it differs and why it matters?
  • The dangers of selective refutation

Diagnosis

  • Early detection of caries, oral cancer, and periodontal disease; more good than harm?
  • Are more dental diagnostic tools better?
  • Guidelines in assessing the value of a diagnostic test
  • False positives

Competencies Addressed

  • UWSOD Competency 19: Utilize information-technology resources in contemporary dental practice.
  • UWSOD Competency 21: Recognize the role of lifelong learning and self-assessment in maintaining competency.
  • UWSOD Competency 22: Utilize critical thinking in assessing technical and scientific information for use in identifying patient needs and treatments.

Course Expectations

To successfully meet the requirements of this course, one is expected to attend lectures, complete two quizzes, participate in discussions, and demonstrate his/her understanding of the lecture material and ability to evaluate the methods and study design of scientific articles through a final examination. Students are also required to complete the on-line course/teaching evaluation. Quizzes are not necessarily announced.

Effective Winter Quarter 2007, completion of on-line course evaluation is a requirement of this course. Failure to comply will result in an “Incomplete” grade being assigned.

Media

*last updated: 11/7/2011

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