Measuring the impact of practice-based research networks on member dentists in the Collaboration on Networked Dental and Oral Health Research, CONDOR

Abstract

Objectives The National Institute of Dental and Craniofacial Research funded three practice-based research networks (PBRNs), NW-PRECEDENT, PEARL and DPBRN to conduct studies relevant to practicing general dentists. These PBRNs collaborated to develop a questionnaire to assess the impact of network participation on changes in practice patterns. This report presents results from the initial administration of the questionnaire. Methods Questionnaires were administered to network dentists and a non-network reference group. Practice patterns including caries diagnosis and treatment, pulp cap materials, third molar extraction, dentin hypersensitivity treatments and endodontic treatment and restoration were assessed by network, years in practice, and level of network participation.Test-retest reliability of the questionnaire was evaluated. Results 950 practitioners completed the questionnaire. Test-retest reliability was good-excellent (kappa>0.4) for most questions. Significant differences in responses by network were not observed. The use of caries risk assessment forms differed by both network participation (p<0.001) and years since dental degree (p=0.026). Recent dental graduates are more likely to recommend third molar removal for preventive reasons (p=0.003). Conclusions Practitioners in the CONDOR research networks are similar to their US colleagues. As a group, however, these practitioners show a more evidence-based approach to their practice. Dental PBRNs have the potential to improve the translation of evidence into daily practice. Designing methods to assess practice change and the associated factors is essential to addressing this important issue.

Understanding dentists’ management of deep carious lesions in permanent teeth: a systematic review and meta-analysis

“…Authors evaluated experience and setting (public versus private practice versus university). McBride [ 35 ] Quest USA, 2009/2010 National, practice based research networks, 66–82 % response, final 950 Lower molar with visible cavitated lesion, deeper than anticipated, may involve pulp (pulpal status not stated) 372/812 CR 285/812 SE 155/812 ET Age was found a factor, with dentists practicing 5–15 years performing ET more often, while those <5 years performed SE more often; full network participant also more likely to perform SE. Stangvaltaite [ 7 ] Quest Norway, 2011 Northern Norway, all dentists, 56 % response, final 222 Deep carious lesion in permanent mature teeth without symptoms and exposure (further scenarios: with symptoms and exposure) Without symptoms and exposure: 104/212 CR, 95/212 SW, 13/212 SE CR versus SE: male OR 1.5 (0.8–2.8), from Norway: 0.5 (0.2–0.9), public practice: 0.6 (0.3–1.3), experienced (5+ years): 1.3 (0.7–2.6), urban: 2.2 (1.2–4.1), main reasons for choosing a strategy were good results, easy, restoration longevity, patients’ health; SW recommended in guidelines.…”

“…Last, statistical evaluation was not accounting for confounders appropriately. Overall risk of bias was high in four studies [ 8 , 9 , 27 , 29 ], moderate in four studies [ 6 , 7 , 34 , 35 ], and low in one study [ 28 ].…”

“… Explanation Reference Capability Knowledge Knowledge of condition, scientific rationale (−) age (younger dentists more likely to perform SE or SW) (+) understanding of caries (acceptance of remaining bacteria being sealed) Younger dentists have different knowledge on caries and the rationale of carious tissue removal. [ 6 – 9 , 27 – 29 , 34 , 35 ] Skills Procedural knowledge, skills, competence, ability (+) dentists oftentimes adopt to new techniques (liners, burs etc.) Many dentists are adopters of technical change; skills are not a barrier for different carious tissue removal.…”

“…A practice network drives a different group dynamics and facilitates change. [ 6 , 9 , 35 ] Social role Professional identity, confidence (?) gender (most studies found female dentists choosing SE or SW more often) Male dentists might have different professional identity which could act as barrier.…”

Patient satisfaction with root canal treatment and outcomes in the Swedish public dental health service: A prospective cohort study

“…Another cause for concern is the reliability of elicited subjective evaluation of therapy or treatment. Few studies in the field of Endodontics have assessed the reliability of the responses to questionnaires, and these have been conducted by different dental care professionals (McBride et al, 2013; Yi et al, 2013). There are no studies which measure the reliability of the responses to questions about patient satisfaction with RCT and its outcomes.…”