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      Developing evidence-based dentistry skills: how to interpret randomized clinical trials and systematic reviews

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          Abstract

          Decision-making based on reliable evidence is more likely to lead to effective and efficient treatments. Evidence-based dentistry was developed, similarly to evidence-based medicine, to help clinicians apply current and valid research findings into their own clinical practice. Interpreting and appraising the literature is fundamental and involves the development of evidence-based dentistry (EBD) skills. Systematic reviews (SRs) of randomized controlled trials (RCTs) are considered to be evidence of the highest level in evaluating the effectiveness of interventions. Furthermore, the assessment of the report of a RCT, as well as a SR, can lead to an estimation of how the study was designed and conducted.

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          Most cited references59

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          Systematic reviews in health care: Assessing the quality of controlled clinical trials.

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            Systematic reviews: synthesis of best evidence for clinical decisions.

            Systematic reviews can help practitioners keep abreast of the medical literature by summarizing large bodies of evidence and helping to explain differences among studies on the same question. A systematic review involves the application of scientific strategies, in ways that limit bias, to the assembly, critical appraisal, and synthesis of all relevant studies that address a specific clinical question. A meta-analysis is a type of systematic review that uses statistical methods to combine and summarize the results of several primary studies. Because the review process itself (like any other type of research) is subject to bias, a useful review requires clear reporting of information obtained using rigorous methods. Used increasingly to inform medical decision making, plan future research agendas, and establish clinical policy, systematic reviews may strengthen the link between best research evidence and optimal health care.
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              The CONSORT statement: revised recommendations for improving the quality of reports of parallel-group randomised trials.

              To comprehend the results of a randomised controlled trial (RCT), readers must understand its design, conduct, analysis, and interpretation. That goal can be achieved only through total transparency from authors. Despite several decades of educational efforts, the reporting of RCTs needs improvement. Investigators and editors developed the original CONSORT (Consolidated Standards of Reporting Trials) statement to help authors improve reporting by use of a checklist and flow diagram. The revised CONSORT statement presented here incorporates new evidence and addresses some criticisms of the original statement. The checklist items pertain to the content of the Title, Abstract, Introduction, Methods, Results, and Discussion. The revised checklist includes 22 items selected because empirical evidence indicates that not reporting this information is associated with biased estimates of treatment effect, or because the information is essential to judge the reliability or relevance of the findings. We intended the flow diagram to depict the passage of participants through an RCT. The revised flow diagram depicts information from four stages of a trial (enrollment, intervention allocation, follow-up, and analysis). The diagram explicitly shows the number of participants, for each intervention group, included in the primary data analysis. Inclusion of these numbers allows the reader to judge whether the authors have done an intention-to-treat analysis. In sum, the CONSORT statement is intended to improve the reporting of an RCT, enabling readers to understand a trial's conduct and to assess the validity of its results.
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                Author and article information

                Contributors
                julikyri@yahoo.gr
                npandis@gmail.com
                pmadian@dent.uoa.gr
                argy_poly@post.harvard.edu
                Journal
                Prog Orthod
                Prog Orthod
                Progress in Orthodontics
                Springer Berlin Heidelberg (Berlin/Heidelberg )
                1723-7785
                2196-1042
                30 October 2014
                30 October 2014
                2014
                : 15
                : 58
                Affiliations
                [ ]Department of Preventive and Community Dentistry, School of Dentistry, University of Athens, 2 Thivon Str, P.O. Box 18018, Athens, 115 27 Greece
                [ ]Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine/Medical Faculty, University of Bern, Freiburgstrasse 7 CH-3010, Bern, Switzerland
                [ ]Department of Periodontology, School of Dentistry, University of Athens, 2 Thivon Str, Athens, 115 27 Greece
                Article
                58
                10.1186/s40510-014-0058-5
                4384902
                054cb3f6-292a-4555-b372-da55230811b6
                © Kiriakou et al.; licensee Springer. 2014

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 1 October 2014
                : 3 October 2014
                Categories
                Review
                Custom metadata
                © The Author(s) 2014

                randomized controlled trials,systematic reviews,critical appraisal,evidence-based dentistry

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