Statement of purpose and methods

doi:10.1016/S1532-3382(03)00086-1

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Volume 3, Issue 3 , Pages 3A-5A, September 2003

Statement of purpose and methods

Article Outline

Abstract
Levels of evidence

Abstract

The Journal of Evidence-Based Dental Practice has two primary goals:

•To improve patient outcomes and health

•To facilitate decision making that results in better patient outcomes, enhanced research planning, better products, and improved policy development.

By reviewing hundreds of original articles from journals published throughout the world, The Journal of Evidence-Based Dental Practice will provide readers with the best, most current clinical information available—information that will improve the outcomes of clinical procedures.

The Journal of Evidence-Based Dental Practice will advocate the use or rejection of a procedure on the basis of explicit statistical and clinical criteria that will be consistently and rigorously applied to the literature. Recommendations and commentary will be presented with an emphasis on objectivity.

The Journal of Evidence-Based Dental Practice will go beyond the reporting of key findings. Commentaries written by leaders in the field will accompany each article. The purpose of the commentaries is two-fold:

•To clearly describe the article's relevance to clinical practice

•To provide a simple and understandable explanation of differences between clinical value and statistical significance.

The Journal of Evidence-Based Dental Practice will provide clinicians with the data they need to continuously improve patient outcomes and will serve as a record of valid, objective research for the academician.

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Levels of evidence

To provide an objective, quantifiable assessment of data, The Journal of Evidence-Based Dental Practice uses as a guide the Levels of Evidence developed by the members of the Centre for Evidence-Based Medicine at Oxford University (Chris Ball, Dave Sackett, Bob Phillips, Brian Haynes, and Sharon Straus). For more information on these Levels of Evidence and their application, please visit the Centre's Web site at http://cebm.jr2.ox.ac.uk/docs/toolbox.html.

In response to reader requests, we have modified the grading system used in the first issue by simplifying it and removing the explanatory remarks found in the original version. Readers are encouraged to visit: http://cebm.jr2.ox.ac.uk/docs/levels.html for the complete and unabridged source of the table. The purpose of assigning these grades is to give the reader a better idea of the quality and strength of the study. A lower grade does not necessarily mean the study has less significance. For example, a first-of-its-kind study with a lower grade may be of great significance. The Journal will continue to refine the grading system.

Levels of Evidence

Level	Therapy/Prevention, Etiology/Harm	Prognosis	Diagnosis	Differential Diagnosis/Symptom Prevalence Study	Economic and Decision Analyses
1a	Systematic review of RCTs	Systematic review of inception cohort studies	Systematic review of Level 1 diagnostic studies	Systematic review of prospective cohort studies	Systematic review of Level 1 economic studies
1b	Individual RCT (with narrow confidence intervals)	Individual inception cohort study	Validating cohort study with good reference	Prospective cohort study with good follow-up	Analysis based on clinically sensible costs or alternatives; systematic review(s) of standards, the evidence; and including multiway sensitivity analyses
2a	Systematic review of cohort studies	Systematic review of either retrospective	Systematic review of Level >2 diagnostic studies	Systematic review of 2b and better studies cohort studies or untreated control groups in RCTs	Systematic review of Level >2 economic studies
2b	Individual cohort study (including low-quality RCT; eg, <80% follow-up)	Retrospective cohort study or follow-up of untreated control patients in an RCT	Exploratory cohort study with good reference standards	Retrospective cohort study, or poor follow-up	Analysis based on clinically sensible costs or alternatives; limited review(s) of the evidence, or single studies; and including multiway sensitivity analyses
2c	“Outcomes” research; ecologic studies	“Outcomes” research		Ecologic studies	Audit or outcomes research
3a	Systematic review of case-control studies		Systematic review of 3b and better studies	Systematic review of 3b and better studies	Systematic review of 3b and better studies
3b	Individual case-control study		Nonconsecutive study; or without consistently applied reference standards	Nonconsecutive cohort study, or very limited population	Analysis of limited alternatives or costs, poor-quality estimates of data, but including sensitivity analyses incorporating clinically sensible variations
4	Case series (and poor-quality cohort and case-control studies)	Case series (and poor-quality prognostic cohort studies)	Case-control study, poor or nonindependent reference standard	Case series or superseded reference standards	Analysis with no sensitivity analysis
5	Expert opinion without explicit critical appraisal, or based on physiology, bench research, or “proof of principle study”	Expert opinion without explicit critical appraisal, or based on physiology, bench research, or “proof of principle study”	Expert opinion without explicit critical appraisal, or based on physiology, bench research, or “proof of principle study”	Expert opinion without explicit critical appraisal, or based on physiology, bench research, or “proof of principle study”	Expert opinion without explicit critical appraisal, or based on economic theory or or based on physiology, bench research, or “proof principle study”

Reference:http://cebm.jr2.ox.ac.uk/docs/levels.html

Article Selection and Review Process

The goal of The Journal of Evidence-Based Dental Practice (JEBDP) is to provide a time- and cost-effective method for dental practitioners to stay apprised of the clinically relevant dental literature. Among the hundreds of dental research articles published monthly, our aim at JEBDP is to identify, abstract, and summarize those articles that address clinically important questions.

For each issue of JEBDP, we screen 22 journals and identify all articles that report on research conducted on at least 100 patients. To ensure the clinical relevance of JEBDP, we then ask a panel of 5 dentists to select from the pool those articles they consider useful and directly relevant to the practicing clinician. If 3 out of the 5 dentists on the panel select an article, it is sent out for review by a content reviewer (an expert in the area), a statistical expert (a person with background in either epidemiology or statistics), and an associate editor. A standardized format is used for all reviews, which allows for a systemic evaluation of the evidence presented in each of the selected articles.

List of Journals

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