In D733, a Clinical Case Analysis of a clinical materials problem will be expected. A written description of a clinical problem the student has encountered in their clinical experience, a related PICO question to the clinical problem, and the search strategy used to find the best available evidence to guide the analysis will be turned in for approval before completing the rest of the analysis. A full description of the assignment is available in the Assignments section for this course in Canvas.
The specific objectives for this Clinical Case Analysis include:
1. Identify a clinical failure, problem, or concern directly related to restorative materials and create a PICO question for it.
2. Search the evidence – create a reference list of the 5-10 pieces of evidence that were most important to your decision making (this is the full reference list).
3. Determine the two pieces of evidence that represent the most important evidence for your PICO and provide an annotation of those two pieces of evidence.
4. Explain the rational for selecting the two pieces of evidence annotated in step 3.
5. Propose steps or actions to be taken in relation to the clinical failure/problem/concern after considering the evidence including a discussion of limitations and generalizability.
The steps to complete this assignment:
1) Select a clinical failure, problem, or concern related in any way to a dental material or its use that you have personally experienced or seen during the examination or treatment of one of your assigned patients. Write a short description of the situation (100 word maximum) and a specific PICO question related to it. No patient identifiers should be used in presenting the material. IF QUERIED, you should be able to provide faculty or teaching assistants with patient identification to allow for a chart review. This description and question must be uploaded into Canvas by 11:00 pm on Thursday, February 1, 2024 for formative evaluation. Suggested changes can and should be incorporated in the final submission.
2) Complete a search for evidence to guide your decision making. Upload your search separately into Canvas as a .cvs file by 11:00 pm on Thursday, February 1, 2024 for formative evaluation. Suggested changes can and should be incorporated in the final submission. Further instructions for completing the search can be found at Search Submission Instructions. Provide full reference citations for the 5-10 pieces of evidence that you located and look to be the most important in heling to determine the course of action for your identified failure, problem, or concern.
3) Select the two pieces of evidence from your full reference list that were the most important and relevant in your decision making. Write an annotated bibliography entry for each of those two pieces of evidence.
4) Discuss the rationale as to why you considered the two pieces of evidence annotated in step 3 to be the most important and most relevant evidence that you located. (150 word maximum per piece of evidence)
5) Based on all of your evidence, give an explanation and justification of steps or actions to be taken in relation to your clinical scenario. Include a discussion of the limitations and generalizability of the stated steps or actions. (250 word maximum)
Structure your analysis submission in the order given above and as laid out in the grading rubric (except for the search as a separate file); 1-scenario and PICO; 2-search (in separate file); 3-two annotations; 4-why the two annotations represent the most important evidence; 5-clinical recommendation based on all evidence; 6-full reference list. The analysis has no minimum length but must be appropriately referenced. All portions of the analysis must be prepared and uploaded into the Canvas assignment no later than 11:00 pm on Friday, March 22, 2024. The grading rubric that will be used to score this activity has been provided as an attachment to this assignment in Canvas. You are strongly encouraged to be familiar with this rubric before submitting your response.
An on-time submission of all parts of the assignment will receive 10 points toward the final grade. A late submission will receive 4 points toward the final grade. Receiving a PASS on the final exercise will result in an additional 10 points toward the final grade in the class.
To PASS the assignment, 3 or more of the 5 rubric sections must be at the “Competent/Acceptable” level with 0 sections scored at the “Novice/Unacceptable” level.
THIS EXCERICISE SERVES AS THE EBD COMPTENCY REQUIREMENT FOR GRADUATION. A PASS MUST BE EARNED ON THIS EXERCISE TO BE CERTIFIED FOR GRADUATION.
Use a library link for Pubmed, particularly if you’re off campus
Make sure you’re in Pubmed and not PMC
DON’T pay for an article. Order through ILL
Searching
Think about the parts of your PICO that are most important:
DON’T use “natural language”
DON’T abbreviate
DON’T use general search words like “comparison”, “cause”, or “versus”
DON’T apply limiters unless you need to
DON’T get too specific too quickly
Think about the variables in your question for initial search words. Is it more important to find specifics based on things related to the “P” or the “I”?
Type of tooth (molar, incisor, etc.) is usually one of the least helpful words to search
Limiters
Limiters need to be turned on and/or added
DON’T use the “Free full text” limiter - THIS WILL RUIN YOUR SEARCH. Using this limiter will eliminate 60-90% of the results you should see.
Limit by “Article Type” first (high level evidence: systematic review, meta-analysis, RCT)
“Review” is usually not the same as “Systematic Review”
Boolean Logic (AND, OR, NOT)
The default is AND
To use a Boolean in Pubmed it must be ALL CAPS (OR, NOT)
Characters like “+” cannot substitute for Booleans
Search History
Make sure you’re in Pubmed. If you’re in MeSH, you’ll see your MeSH history, not your actual Pubmed history
To grade them, we must be able to read and understand your searches well enough to recreate them
The Clinical Case Analysis and search history should be submitted as two attachments in Canvas. The search history should be submitted as a .csv file. Instructions for saving your PubMed search history are as follows:
Annotated Bibliography for Electronic Cigarettes PICO/Search
[CITATION - make sure the citation is in the proper style (AMA, APA, etc.)]
Franck C, Budlovsky T, Fillion KB, Windle SB, Eisenberg MJ. Electronic cigarettes in North America: history, use, and implications for smoking cessation. Circulation. 2014; 129(19): 1945-52.
[DESCRIPTION & EVALUATION - every annotation should include information about the resource, why it is inherently good and why it is good in the context of your research. It should not just be a restating of the abstract.]
This study is a systematic review of the literature on electronic cigarettes and the use of electronic cigarettes in smoking cessation, published in 2014 in the peer-reviewed journal Circulation, a journal of the American Heart Association. The authors are associated with the Lady Davis Institute for Medical Research, the research arm of McGill University, Montreal, QC, Canada. The intended audience is health care specialists and in particular physicians, nurses and others interested in cardiovascular medicine. The authors clearly outline their search strategy as well as inclusion and exclusion criteria. The review was limited by the fact that only 7 studies met the inclusion criteria, and of these only 1 was a randomized controlled trial. One of the authors disclosed funding from a company that manufactures a tobacco cessation drug, which could lead to bias against the effectiveness of e-cigarettes as a cessation adjunct.
[CLINICAL APPLICATION - NOT EVERY ANNOTATED BIBLIOGRAPHY ANNOTATION WILL HAVE THIS!! Only include this if you actually have a scenario and PICO question as your research objective.]
I selected this study/article for inclusion in my annotated bibliography because it was the only systematic review that I found with my search. While only one of the studies included in the review was a RCT, other studies did assess the possible modification of smoking behavior among selected populations. The authors included discussions of limitations to generalization, including the populations studied and overestimated power calculations, and conclude that there is insufficient research on electronic cigarettes to determine their contribution to smoking or to smoking cessation at this time. While the evidence may look somewhat promising, I would not recommend an electronic cigarette to my patients as an effective cessation aid.
IUPUI