The core of evidence-based dentistry (EBD) is the systematic review (SR). A SR is the product of a systematic process of review examination and synthesis of the research literature identified to pertain to a specific clinical question. The clinical question arises from the patient-clinician encounter, and is crafted along four dimensions: the patient (P), the interventions (I) under consideration for comparison (C), and the specific clinical outcome (O) sought. The PICO question sets the direction of the research synthesis that evaluates and assesses the level and the quality of the evidence obtained in the identified literature (i.e., the bibliome) responding to the PICO question. These data are analyzed statiscally via the acceptable sampling and the meta-analysis protocols; and a consensus of the best available evidence is obtained, and reported in the SR. Multiple SR's can be combined through a similar process to yield Clinically Relevant Complex Systematic Reviews (CRCSRs). The best available evidence can be used in a logic model of clinical decision-making to ensure patient-directed treatment efficacy. Alternatively, the effectiveness (cost, risk/benefit) of treatment modalities can be estimated, using the best available evidence, in a utility-, probability-based decision-making process.
Taken together, these activities are patient-centered, and in fact they often are intertwined with translational research. These activities are driven by the PICO research question (i.e., hypothesis-driven), and follow the 5 essential steps of the scientific method (hypothesis, methodology (design, sample, measurement), production of quantified data, statistical analysis of the data, and inferential conclusion). These activities are specifically intended to yield comparative assessments for efficacy and/or effectiveness, and with direct applications and implications to dental practice - hence, the acronym CEERAP (comparative efficacy and effectiveness research and analysis for practice).
The key to an efficient model of evidence-based dentistry lies in the bi-directional transaction from the patient to research, and from research outcomes back to the patient. That is to say, not only must EBD be grounded on translational research, but the best available evidence produced by the SRs and the CRCSRs that dictate the efficacy, and more so the effectiveness outcomes must be directed back to the immediate benefit of the patient. Thus, we speak of translational effectiveness as the process by which the identified best available evidence finds its way in specific clinical setttings.
The level of complexity of the science of research synthesis in dentistry - i.e., evidence-based dentistry - demands concerted collaborative efforts on the part of the academic research and training environment, dental practices in the community, local, national and international professional organizations and patient groups, and various other stakeholders. In particular, the transaction between academia and the community dental practices is essential.
The network of research collaboration between academia and dental practices is what is defined as the Practice-Based Research Network (PBRN).
This site is the hub and the home for our PBRN dedicated to EBD. Our PBRN (EBD-PBRN) is centered at UCLA School of Dentistry (i.e., the EBD Research Group, Oral Pathology, UCLA Dental Clinic), and involves dental practices in Los Angeles and Orange Counties, as well as the Mission Community Hospital-San Fernando Campus. Our PBRN extends to Europe (Stomatology Institute in Italy; EBD Center, University of Lisbon, Portugal), Latin America (School of Dentistry, Belo Horizonte University, Brazil), and Asia (KAU University, Saudi Arabia). It comprises both the Western medical and the Eastern medical traditions, including Traditional Chinese Medicine, and Ayruvedic Medicine).
Our EBD-PBRN is affiliated with the UCLA Clinical and Translational Science Institute (CTSI), an entity supported by the National Institutes of Health for the purpose of promoting translational effectiveness. Our EBD-PBRN is also endorsed by the EBD Center of the American Dental Association.