EBD is sequential, systematic process of addressing a clinical or community relevant problems. EBD components are; Clinical expertise Patient’s preferences & values Highest level of evidence

2. • EBD is sequential, systematic process of addressing a
clinical or community relevant problems.
• EBD components are;
–Clinical expertise
–Patient’s preferences & values
–Highest level of evidence

3. 1. Identification of a Clinical Problem
2. Search for Evidence
3. Making Sense of Evidence
4. Act on Evidence

4. Identification of a Clinical Problem
–P = patient/ population/ problem (among_____?)
–I = Intervention / Exposure (does_______?)
–C= Comparison (versus_______?)
–O= Outcome (affect________?)
• Understand 2 Ts; Type of question & Type of
research desighn - PICOTT

5. • Q. Is ischlorhexadine varnish more effective than sodium
fluoride varnish in preventing root caries? (seeks
evidence of effectiveness of treatment) P I C O
• Q. Will chronic smokers experience delayed
osteointegration after implant placement? (seeks
evidence of ascertain causes or risk factors)

6. • Quality of evidence: Systematic review rather than
individual study for any type of question
• hierarchy of of research designs based on quality of
research design - Evidence Pyramid

8. Step 2: Search for Evidence
1. Primary Evidence: Original Articles
2. Secodary Evidence: Studies of studies/ systematic
reviews
WHERE DO WE SEARCH FOR EVIDENCE?

9. WHERE DO WE SEARCH FOR EVIDENCE?
• Search engines: i-e google & google scholar. It search
the WEBSITES
• Meta- search engines: i-e SUM search & BIOME. It
search the SEARCH ENGINE & DATABASES.
• Databases: electronic bibliographic database is an
exhaustive resource of QUALITY RESEARCH, constantly
updated on all aspects of a scientific field.

10. Important general medical databases
1. Cochrane Library of Systematic Reviews ; by cochrane
approved reviewers
2. MEDLINE ;indexes over 5000 journals based on quality
review by US.National Library of Medicine.
• indexed journals are higher scientific quality as compared to non-
indexed journals

11. Important general medical databases
3. PubMed; is a freely available database, which contains
all the journals indexed by MEDLINE.
Developed by US National Library of Medicine &
National Center for Biotechnology Information.
4. EMBASE; important because of update on DRUGS /
PHARMACOLOGY

12. Step 3: Making Sense of Evidence
1. Important component to sense evidence are;
1. study quality( methodological quality including statistics)
2. Bias (systematic errors)
3. Internal Validity (validity)
4. External Validity (generalizability, applicability)
2. Recovered evidence should be appraised/ evaluate
3. Update new evidence & discard poor evidence

13. Step 4: Act On Evidence
• Good quality of evidence gives strength to
recommendation.
• Strength of recommendations due to quality evidence will
do more good than harm.
• EBD demands evidence on treatment plan depends must
have lowest possible risk of bias.

14. • The process of integrating science based intervention
which community preferences to improve the health of
populations.
• Define by

15. Ciliska D et al
2008)

16. • Hence EBPH decision-making will include essentially all
the steps in EBD with emphasis on the public health
resources, the dynamics of the communities and
diversities of the socities on whom the interventions will
apply.

18. • Peer-reviewed or refereed journals have an editorial
board of subject experts who review and evaluate
submitted articles before accepting them for publication.
• A journal may be a scholarly journal but not a peer-
reviewed journal.

20. • When a manuscript is submitted to a journal, it is
assessed to see if it meets the criteria for submission. If it
does, the editorial team will select potential peer
reviewers within the field of research to peer-review the
manuscript and make recommendations.

22. • Single-blind: the reviewers know the names of the
authors
• Double-blind: reviewers & authors both dont know
names of each other
• Open peer: authors know who the reviewers are, and
the reviewers know who the authors are.

23. • Transparent peer: the reviewers know the names of
the authors, but the authors do not know who reviewed
their manuscript unless the reviewer chooses to sign their
report. If the manuscript is accepted, the anonymous
reviewer reports are published alongside the article and
the authors’ response to the reviewer.