Biomedical subjects

Janet Bauer

Publications and source records attributed to Janet Bauer.

7 recordsLinked to original sources

PubMed2006

Evidence-based dentistry: fundamentals for the dentist.

This article explains the fundamentals of evidence-based dentistry for the dentist. Evidence-based dentistry is a discipline whose primary participant is the translational researcher. Recent developments have emphasized the importance of this discipline (clinical and translational research) for improving health care. The process of evidence-based dentistry is the reciprocation of new and existing evidence between dentists and quantitative and qualitative researchers, facilitated by the translational researcher. The product of this reciprocation is the clinical practice guideline, or best evidence, that provides the patient options in choosing treatments or services. These options are quantified and qualified by decision, utility, and cost data. Using shared decision-making, the dentist and patient arrive at a mutual understanding of which option best meets an acceptable and preferred treatment course that is cost effective. This option becomes the clinical decision.

Decision Making↗

PubMed2006

Evidence-based dentistry: a clinician's perspective.

Evidence-based dentistry is a discipline that provides best, explicit-based evidence to dentists and their patients in shared decision-making. Currently, dentists are being trained and directed to adopt the role of translational researchers in developing evidence-based dental practices. Practically, evidence-based dentistry is not usable in its current mode for the provision of labor-intensive services that characterize current dental practice. The purpose of this article is to introduce a model of evidence-based dental practice. This model conceptualizes a team approach in explaining problems and solutions to change current dental practice. These changes constitute an evidence-based dental practice that involves the electronic chart, centralized database, knowledge management software, and personnel in optimizing effective oral health care to dental patients.

Databases as Topic↗

PubMed2006

Making clinical decisions using a clinical practice guideline.

Clinical practice guidelines are statements developed from best evidence about clinically relevant appropriate care. A simulated patient case is presented to demonstrate how to use a CPG in decision-making in determining a clinical decision. Conceptualized knowledge management software templates are provided to explain a process by which best evidence is retrieved from a primary, centralized network database. Templates describe the process of converting a clinical question into a research question, retrieving best evidence, and performing data analysis for the outcome of individualizing and optimizing a clinical decision. Templates also describe the reciprocation of information to update CPGs by translational researchers who manage and build the primary, centralized network database.

Aged, 80 and over↗

PubMed2005

Evidence-based decision making in dental practice.

For an evidence-based dental practice, shared decision making is made possible using an intuitive or analytic approach in reconciling best evidence and patient characteristics and preferences. Decision trees assist the dentist when presenting conditions and patient values are less certain in recommending treatment modalities whose benefits and harms are variable or unknown. Using clinical practice guidelines (or protocols organized within a decision tree), best evidence, based on the "average patient", is integrated into the decision tree. Probability, utility, and economic data are calculated and analyzed in providing the patient with informed and individualized choices of care. Evidence-based decision making results in a process in which an individual patient is informed of the best available evidence and all relevant options. The outcome of the process is that patient utilities and cost concerns are fully addressed in optimizing the clinical decision.

Journal Article↗

PubMed2005

Model of evidence-based dental decision making.

Shared decision making empowers patients as informed consumers, helping them to make clinical decisions that optimize their personal oral health. Evidence-based dentistry supports this process by providing best evidence that, when presented in visual and interactive formats, focuses consultation time on treatment or therapy options and their trade-offs. Currently, an explosion of evidence and technological advancements have necessitated a cooperation that translates into an interdisciplinary approach to care delivery. For evidence-based dentistry, this interdisciplinary approach includes the interaction of researchers, clinicians, and patients in promoting individual patient care. To facilitate this interaction, a computerized model of evidence-based dental decision making is presented to manage knowledge in its application to clinical practice. This model includes the use of decision aids and a decision tree composed of multiple clinical practice guidelines. These aids allow for quantifying treatment options in terms of estimates using probability, utility, and cost data. With these estimates, decision analysis and the flexibility to manipulate data provide patients with increased control and acceptance of the decisions that they make about their personal oral health.

Editorial↗

PubMed2002

Psychoneuroimmunology in oral biology and medicine: the model of oral lichen planus.

Rheumatoid arthritis involves psychoneuroendocrine-immunopathological comorbidities. In the stoma, patients with rheumatoid arthritis frequently show signs of periondontal disease consequent to elevated levels of crevicular proinflammatory cytokines. It is not clear whether rheumatoid arthritis may manifest in association with immunopathological manifestations of the oral soft mucosa. Oral lichen planus (OLP), first described by E. Wilson in 1859, is a T-cell-mediated inflammatory disease whose lesions characteristically lack B cells, plasma cells, immunoglobulin. or complement. It is increasingly well characterized and recognized as a model for psychoneuroimmunology research in oral biology and medicine. To date, we have shown an association between changes in hypothalamic-pituitary-adrenal (HPA) regulation, systemic markers of cellular immunity and mood states, with clinical stages of OLP (i.e., atrophic vs. erosive vs. bullous lesions). We report significant associations (p < 0.05) between the stage of OLP, HPA deregulation, and altered distribution and functional responses of naïve CD4(+) cells. We emphasize the need to study in greater details the psychoneuroendocrine-immune inter-relationships in OLP, and we propose a novel neuroimmune hypothesis for OLP.

Apoptosis↗

PubMedDate not supplied

Dental needs of the elderly in the 21st century.

The average age of the world's population is increasing rapidly. The "graying of America" presents new opportunities and new challenges for improving the oral health of the elderly, particularly those afflicted with neurocognitive impairments. The dental problems associated with these conditions include but are not limited to a decrease in oral hygiene; difficulty in controlling and retaining dentures; xerostomia, which often is drug-associated, and consequential root caries, recurrent decay, and purposeless chewing. Parkinson's disease and Alzheimer's disease are the most prevalent type of progressive neurocognitive impairing illnesses, affecting millions of elderly Americans. As the adult population increases, a greater number of patients with these diagnoses will require dental care. Dental providers need to be aware of the special problems associated with the treatment of the older healthy subject and the neurocognitively impaired patient.

Adult↗