Sources of Evidence/Information
The aim of this chapter is to briefly outline some of the major sources of information available.
After completing this chapter you will be aware of a range of databases and other electronic resources to obtain information.
Traditionally, dentists, like other healthcare professionals, have found their evidence from:
For those with academic links or who are regular attendees at postgraduate meetings, a lecture by an expert is often a useful way of keeping in touch. However, the traditional lecture has been shown to be of little use for postgraduate education apart from the imparting of facts, much of which (75%) will be forgotten. Your own notes (if they can be read) may provide you with sources for future study, while the speaker may provide handouts with references which could be useful later. Most lectures however, although of interest, are rarely of immediate clinical importance to you or your patients and as such will be rapidly forgotten.
Textbooks are a source of reference for many. However, they date rapidly and due to the publishing process many are out of date as soon as, if not before, they are published.
There are an increasing number of journals being published in the biomedical field – reputedly over 30,000 worldwide. Of these, in excess of 500 are specific to dentistry alone, with some 400 of these being referenced on MEDLINE, the bibliographic database (see later). Journals come in all shapes and sizes, from the highly esoteric single-issue variety such as Caries Research, through to general journals such as the British Dental Journal. The quality control or peer review processes varies from the strict to the non-existent.
These journals present a vast array of information to the practising dentist, not all of which is good quality or readily available. For example, research in three specialities has given some indication of how many articles in a wide range of journals a dentist in these specialities would need to read per week to keep up to date (Table 13-1).
|Articles per week||No. of journals|
1Yang et al., 2001; 2Nishimura et al., 2002; 3Kim et al., 2001.
Papers in journals are often published a year or two following the data collection and in one example in a new journal the data presented related to material more than 20 years old, which was not immediately obvious to the reader.
The coming of the information age, with the development of the internet, the move to electronic publishing and changes in printing technology, has led to a major increase in the amount of scientific literature.
The development of PubMed, a freely accessible database providing access to citations from the biomedical literature, by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM), located at the US National Institutes of Health (NIH) in the USA, and the National Electronic Library for Health (now the National Library for Health) in the UK, were highly significant in this regard.
The evidence-based movement has seen the development of secondary journals in a range of areas – medicine, mental health, dentistry. These journals all produce short summaries of high-quality evidence, significantly reducing the number of articles that practitioners need to keep up to date. In addition the internet has seen an explosion of information available from specialist sites.
All of this means that there are three main groups of information resources available to those with an internet connection:
Here we outline a range of useful databases for those interested in evidence-based practice. Access arrangements to these vary in different countries. In the UK, access is either available free or to NHS staff using an Athens password.
The Cochrane Library is published on a quarterly basis and contains a number of databases:
Cochrane Database of Systematic Reviews
Database of Abstracts of Reviews of Effects (DARE)
Cochrane Central Register of Controlled Trials (CENTRAL)
Cochrane Methodology Register