Naoki Kakudate1, Yoko Yokoyama2, Futoshi Sumida3, Yuki Matsumoto4, Tomoka Takata5, Valeria V Gordan6, Gregg H Gilbert7. 1. Division of Clinical Epidemiology, Kyushu Dental University, 2-6-1, Manazuru, Kokura-kita, Kitakyushu, Fukuoka, 803-8580, Japan; University of Florida College of Dentistry, P.O. Box 100415, Gainesville, FL 32610-0415, USA. Electronic address: r13kakudate@fa.kyu-dent.ac.jp. 2. Graduate School of Media and Governance, Keio University, 5322 Endo Fujisawa, Kanagawa, 252-0882, Japan. 3. Daiich Dental Clinic, 5-5-7, Hanazono, Chitose, Hokkaido, 066-0028, Japan. 4. Matsumoto Dental Clinic, 24-3, Komanomai, Doimachi, Okazaki, Aichi, 444-0204, Japan. 5. School of Dentistry, Kyushu Dental University, 2-6-1, Manazuru, Kokura-kita, Kitakyushu, Fukuoka, 803-8580, Japan. 6. Department of Restorative Dental Sciences at the University of Florida College of Dentistry, Room D3-39 P.O. Box 100415 Gainesville, FL 32610-0415, USA. 7. Department of Clinical and Community Sciences, School of Dentistry, University of Alabama at Birmingham, Room SDB 109, 1720 Second Avenue South, Birmingham, AL 35294-0007, USA.
Abstract
OBJECTIVES: To determine whether: the evidence-practice gap (EPG) in minimal intervention dentistry (MID) can be improved by a tailored web-based intervention, and specific clinical situations might impede implementing MID. METHODS: We conducted a before-after intervention study and a qualitative study. Two web-based questionnaire surveys were conducted among 197 Japanese dentists. In the first questionnaire, a baseline EPG was measured using six questionnaire items. Subsequently, feedback material about the EPG was electronically prepared, including results of the first questionnaire, international comparisons with a previous study from the US, and a summary of recent evidence on MID. In the second questionnaire, the EPG was re-measured after participants read the material. The primary outcome was mean overall concordance between published evidence and the dentist's clinical practice for all six questions. During the second questionnaire, we performed qualitative content analysis using free-text responses to a question about difficult situations encountered when conducting MID. RESULTS: Regarding before and after comparisons of concordance between the first and second questionnaires, mean overall concordance improved significantly, from 66% to 89% (p<0.001). Qualitative content analysis identified five difficult situations: "cases where decision making for treatment and prognosis is difficult", "inadequate practice resources", "limitations on patient visit and treatment period", "discrepancy between MID and the patient's values", and "limitations on health insurance and social understanding". CONCLUSIONS: These results suggest that it is possible to reduce the EPG in MID using a web-based educational intervention among Japanese dentists. Qualitative content analysis revealed five difficult situations that might hinder implementation of MID. CLINICAL SIGNIFICANCE: Although this intervention demonstrated educational effects, perfect concordance was not achieved by all participants. This is possibly associated with the five situations that participants reported facing when conducting MID. Creating an environment to improve these situations may facilitate a reduction in the EPG.
OBJECTIVES: To determine whether: the evidence-practice gap (EPG) in minimal intervention dentistry (MID) can be improved by a tailored web-based intervention, and specific clinical situations might impede implementing MID. METHODS: We conducted a before-after intervention study and a qualitative study. Two web-based questionnaire surveys were conducted among 197 Japanese dentists. In the first questionnaire, a baseline EPG was measured using six questionnaire items. Subsequently, feedback material about the EPG was electronically prepared, including results of the first questionnaire, international comparisons with a previous study from the US, and a summary of recent evidence on MID. In the second questionnaire, the EPG was re-measured after participants read the material. The primary outcome was mean overall concordance between published evidence and the dentist's clinical practice for all six questions. During the second questionnaire, we performed qualitative content analysis using free-text responses to a question about difficult situations encountered when conducting MID. RESULTS: Regarding before and after comparisons of concordance between the first and second questionnaires, mean overall concordance improved significantly, from 66% to 89% (p<0.001). Qualitative content analysis identified five difficult situations: "cases where decision making for treatment and prognosis is difficult", "inadequate practice resources", "limitations on patient visit and treatment period", "discrepancy between MID and the patient's values", and "limitations on health insurance and social understanding". CONCLUSIONS: These results suggest that it is possible to reduce the EPG in MID using a web-based educational intervention among Japanese dentists. Qualitative content analysis revealed five difficult situations that might hinder implementation of MID. CLINICAL SIGNIFICANCE: Although this intervention demonstrated educational effects, perfect concordance was not achieved by all participants. This is possibly associated with the five situations that participants reported facing when conducting MID. Creating an environment to improve these situations may facilitate a reduction in the EPG.
Authors: David A Cook; Anthony J Levinson; Sarah Garside; Denise M Dupras; Patricia J Erwin; Victor M Montori Journal: JAMA Date: 2008-09-10 Impact factor: 56.272
Authors: Gregg H Gilbert; Jeffrey L Fellows; Veerasathpurush Allareddy; David L Cochran; Joana Cunha-Cruz; Valeria V Gordan; Mary Ann McBurnie; Cyril Meyerowitz; Rahma Mungia; D Brad Rindal Journal: J Clin Transl Sci Date: 2022-06-22