PubMed · 10279469
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J Kneedler. 1985. Evaluating software for the OR.. https://pubmed.ncbi.nlm.nih.gov/10279469/
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For medical decisions with more than one reasonable option, patient participation in decision making is often necessary to optimally match management decisions with patient preferences. Health decision aids are designed to facilitate shared decision making by helping patients and their physicians choose among reasonable clinical options. Although these aids vary in content, common denominators are the presentation of more than one reasonable strategy for a clinical management question and a description of the possible outcomes of the various options. Although the number of published randomized trials assessing the impact of health decision aids on the quality of medical decisions is limited (but growing), various types of decision aids do generally appear to inform patients about their treatment options better than "usual care" can. Little evidence is available to determine whether one type of decision aid is optimal, but more complicated programs seem to have larger effects. The cost-effectiveness of decision aids has not been studied, although it is enticing to think that the pattern of more conservative decisions by users of some decision aids could reduce medical care costs in a manner that is dictated by patient preferences.
In dentistry, most changes in therapy come from new techniques and products that are introduced to the market. Clinicians (and patients) can be overwhelmed by advertisements and marketing, some obvious and some (e.g., paid clinical reports in non-peer-reviewed journals) not so obvious. Because most advances are made with small case studies, which are at a lower level of evidence, it is imperative that data clinicians read or see have the greatest validity possible. This validity is imperative to achieve evidence-based dentistry that uses relevant, high-quality, clinically oriented research that provides better information for the clinician and better treatment for the patient.
It should be evident by now that evidence based dentistry leaves much room for the application of clinical judgment to the literature. This article points out that judgment in evaluating certain factors is essential and that the practice of evidence based dentistry is not a process of blindly following the conclusions found in the literature. Clinicians can safeguard the patient and themselves against the inappropriate use of weak or irrelevant evidence in the conduct of daily practice. This skill adds confidence to decision making in clinical practice and prevents the decline in skills throughout a career.