Evidence-Based Dentistry (EBD)

It is not enough to craft a search for evidence, you now must look through your results and select which articles are most appropriate to use in answering your foreground question.

The goal of the EBD search process is to help you find the best answer possible as quickly as possible. 

We recommend when selecting articles to meet these basic criteria:

• At least two articles
• Published within the last 10 years
• Each must address the identified most important concept in the PICO question
• The sum of the articles together must address both the I and the C
• Ideally one filtered article AND one unfiltered article
• If no filtered, then two unfiltered is fine OR if you are looking at the I and C separately (combining them with OR) then two filtered is fine.

What if you can't find any good articles? We recommend revisiting your search strategy. Is there any way it could be broadened or otherwise improved? Try at least one alternate search strategy. If after trying at least two search strategies you feel confident that only one or zero good quality articles exist on your topic then that fact needs to be considered in the EBD decision.

As you spend time in the profession, your ability to do this will improve. In the meantime, you may wish to refer to an Evidence Pyramid to help you select articles. The Evidence Pyramid we teach is based in part upon the Center for Evidence-Based Medicine (CEBM) Levels of Evidence and in part upon the Evidence Based Nursing Practice tutorial by Library Faculty at Scottsdale Community College. It gives greater detail on how the domain of the question being asked impacts article selection.

“Evidence Pyramid” by Tufts University can be reused under the BY-NC-SA license 4.0

The Evidence Pyramid is meant to be used as a reminder and a reference. If you are not already familiar with it, we encourage you to visit the entire tutorial to learn how to use it to help you.

Relevant Tutorial

Learn more with the Selecting the Evidence tutorial. 

Select your format:

• PDF handout (8 minutes estimated reading time)
• Video with captions (08:44 duration)
• Video without captions (08:44 duration)

Each article you select must be appraised for quality. What do we mean by that?

The goal is to compare the study to indicators of quality for that type of study. In order to do this you need to:

1. Identify strengths (what indicators of quality were done well)
2. Identify limitations (what indicators of quality could have been improved upon)
3. Consider applicability to your own patient population.

It's important to note that you can use a study on different patient populations BUT you need to be sure to acknowledge the differences and potential impact of them.

In order to do quality appraisal successfully you must understand study design and indicators of quality. If you are not already comfortable with both of these, check out the relevant tutorial below for a quick introduction to study types and specific indicators of quality for each.

Relevant Tutorial

Learn more with the Appraising the Evidence tutorial. 

Select your format:

• PDF handout (10 minutes estimated reading time)
• Video with captions (13:22 duration)
• Video without captions (13:22 duration)

Various organizations provide checklists to aid with quality appraisal. These are often more in-depth that the basic guidelines given in our tutorial. If you want to go deeper in your quality appraisal, you may wish to check these out.

AMSTAR (A Measurement Tool to Assess Systematic Reviews) Checklist
An appraisal tool to evaluate systematic reviews.

CASP (Critical Appraisal Skills Programme)
Provides checklists, elearning, and workshops on critical appraisal.

CONSORT (Consolidated Standards of Reporting Trials)
An evidence-based, minimum set of recommendations for reporting randomized trials. It offers a standard way for authors to prepare reports of trial findings, facilitating their complete and transparent reporting, and aiding their critical appraisal and interpretation.

SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials) Checklist
Provides recommendations for a minimum set of scientific, ethical, and administrative elements that should be addressed in a clinical trial protocol.