Concordance between practice and evidence: The National Dental PBRN [presentation] Presentation uri icon

abstract

  • Objective: To characterize concordance between clinical practice and published evidence for a range of preventive, diagnostic and treatment practices among dentists in the National Dental Practice-Based Research Network. Method: Participants included network dentists who completed two separate questionnaires. The first questionnaire was administered as part of network enrollment and collected demographic characteristics (e.g., gender, race/ethnicity, type of practice). The second questionnaire was administered as part of a larger study, and, among other items, asked dentists to indicate how they treat their patients across 14 preventive, diagnostic and treatment scenarios and actual practice behaviors (e.g., pulp capping, caries diagnosis and treatment). Response options to scenarios and behaviors were coded as consistent or inconsistent with available published evidence. To examine concordance between practice and evidence, we summed responses to the 14 questions; responses consistent with the evidence were coded as ‘1’ and responses inconsistent with the evidence were coded as ‘0’, and divided by the number of all non-missing. This created an overall ‘concordance’ score, calculated as percent of responses that were consistent with the evidence, with a higher percentage indicating greater concordance between practice and evidence. Result: A total of 657 dentists completed both questionnaires; analyses for the present study are limited to participants in the U.S. (n = 591), most of whom were male (82%), non-Hispanic White (89%), and in general practice (95%). Mean concordance score was 53% (SD: 17) and ranged from 7%-100%. In adjusted analyses, affiliation with a large group practice was significantly associated with higher performance (p = 0.05); no other factors were significantly associated with performance. Conclusion: Dentists reported variability in concordance between responses to scenarios/practice behaviors and published evidence. Additional research is needed to understand the discrepancy between reported clinical practice and published evidence.