Information-seeking behaviors and barriers to the incorporation of scientific evidence into clinical practice: A survey with Brazilian dentists

Abstract

The aim of this online cross-sectional study is to identify the sources of scientific information used by Brazilian dentists in clinical decision-making and the barriers that they perceive as important to the incorporation of scientific evidence into clinical practice. A pretested questionnaire created in Google Forms which was made available to participants through links sent by e-mail or shared on Facebook® and Instagram® was used to collect the data between October 2018 and May 2019. Only dentists who were involved in direct or indirect care of patients (i.e. clinicians who performed dental procedures or dental educators who participated in the clinical training of graduate or postgraduate dental students) were asked to complete the questionnaire. The sample was comprised of 528 dentists (the response rate from the alumni database was 6.9%); their mean age was 45.2 years (±12.5) and 30.9% had an academic position. The majority were women (68.0%) and lived in Southern or Southeastern Brazil (96.0%). The sources of scientific information more frequently used by them in clinical decision-making were clinical guidelines (65.1%; 95% CI: 60.9, 69.2), scientific articles (56.8%; 95%CI: 52.5, 61.1) and bibliographic databases (48.3%; 95% CI: 43.9, 52.6). The information resource less frequently used was social media. The most important barriers to the clinical use of scientific evidence were: difficulty in determining whether scientific contents found on the Internet were reliable or not (41.8%; 95% CI: 37.6, 46.2), high cost of access to scientific papers (37.7%; 95% CI: 33.5, 41.9), and lack of time for reading scientific articles (32.4%; 95% CI: 28.4, 36.6). Although Brazilian dentists show a positive attitude towards obtaining scientific evidence from reliable sources, there still remain important barriers to the translation of evidence into practice. This can have significant implications for quality of care and should be further investigated.

Retrieving Cochrane reviews is sometimes challenging and their reporting is not always optimal

“…Second, there is evidence that the Cochrane library is not used as the first source to retrieve evidence. PubMed is used more frequently than the Cochrane Library for information retrieval in daily practice 10–12 …”

“…PubMed is used more frequently than the Cochrane Library for information retrieval in daily practice. [10][11][12] There are potential solutions to these issues raised. First, actions should be taken such that Cochrane reviews adhere with the PRISMA recommendations.…”

“…This is especially of relevance as PubMed is one of the most important sources where clinicians and health care professionals search for evidence, whereas the Cochrane Library is rarely used by them. [10][11][12] Consequently, clinicians and health care professionals might not be able to retrieve Cochrane reviews even when they are available. However, we admit that there is no evidence on how ad hoc searches in PubMed or other databases are performed.…”

Manejo de cárie radicular: um guia para o dentista brasileiro baseado na tradução e adaptação cultural do consenso internacional/ORCA E EFCD

“…Esse tópico não foi discutido no consenso. O fator de indicação mais importante entre as duas técnicas é a quantidade de estrutura dentária remanescente, e as questões técnicas de dificuldade de produção intraoral, que podem ser compensadas por passos extraorais 18 . A técnica direta deve ser sempre a primeira escolha, pois permite máxima preservação da estrutura dentária, geralmente realizado em uma consulta e seus custos são relativamente baixos.…”

“…Recentemente, um estudo demonstrou que 23% dos dentistas brasileiros não tem proficiência para buscar informações de evidências científicas em textos na língua inglesa 18 . Diante do exposto, este estudo teve como objetivo elaborar e adaptar um guia para tomada de decisão clínica baseada em evidências científicas sobre o tratamento da cárie radicular dentro do contexto brasileiro, a partir da tradução das recomendações de consenso internacional.…”