Scientific Communication How many scientists does it take to screw in a light bulb? 12/10/2018

The Course Our perspective Your expectations? The web site Understand the scientific process Understand the “business” of research Learn how to evaluate a clinical research study Learn to distinguish between “good” and “suspect” research Understand the basic approach to evidence-based dentistry Your expectations? The web site www.umich.edu/~bmsteach/lopatin/communications/index.html 12/10/2018 Dennis E. Lopatin, Ph.D.

Finding the Answer 12/10/2018 Dennis E. Lopatin, Ph.D.

Finding the Answer Clinical practice requires the use of the “best” solution to a patient’s problem Scientific investigation does not generally focus on a single patient’s problem. Basic biological mechanisms Population issues Materials properties The “consumer” clinician must “crystallize” the problem and utilize the best information resources to address it. 12/10/2018 Dennis E. Lopatin, Ph.D.

Both begin with a question to be answered Similarities between finding the answer in research and in clinical practice Both begin with a question to be answered Focused clinical question Hypothesis Strategy to answer question is developed Search existing information Implement best solution to problem Treat patient Perform experiment 12/10/2018 Dennis E. Lopatin, Ph.D.

Research Path Research Problem Study Design Formulate the hypothesis based on best available literature Hypothesis can be answered either true or false Types of problems Prognosis Prevention/treatment Diagnosis Causation, etiology, harm Study Design What is the best model with which to test hypothesis 12/10/2018 Dennis E. Lopatin, Ph.D.

Research Path (cont’d) Obtain IRB approval Peer Review (Institutional Review Board) Obtain funding for study Peer Review (Study Section, Foundation Committee Industry (Research Manager, Marketing Group, etc.) Perform study Perform data analysis Confirm or disprove hypothesis Submit findings for publication Peer review Technical Report Lay Press 12/10/2018 Dennis E. Lopatin, Ph.D.

Research Path (cont’d) Publication in public domain Print Electronic Presentation at meetings Findings accessible to “outside” world Medline (NLM) and other biological databases Websites Infomercial Lay Press Findings generate new questions 12/10/2018 Dennis E. Lopatin, Ph.D.

Issues that influence research Investigator bias National funding priorities Industrial funding priorities Peer reviewer bias at funding and publication levels 12/10/2018 Dennis E. Lopatin, Ph.D.

Finding the answer for a specific patient A “problem” presents itself (the patient walks in the door) Prevention or treatment Diagnosis Prognosis Causation/etiology/harm Define the problem Develop a focused clinical question to aid in finding the “right”solution 12/10/2018 Dennis E. Lopatin, Ph.D.

Finding the answer for a specific patient (cont’d.) The focused question addresses/defines: The patient and/or the problem The intervention/treatment/prognostic factor under consideration The comparison intervention/treatment/prognostic factor (may not be one) Desired outcome 12/10/2018 Dennis E. Lopatin, Ph.D.

Developing a focused question (Center for Evidence-Based Medicine) Focused question table CEBM 12/10/2018 Dennis E. Lopatin, Ph.D.

Define the search strategy Sensitivity and specificity of the search (hedges and filters) Identify the information resources Medline and other electronic databases Cochrane Database of Systematic Reviews Reviews and Meta-analyses Clinical Practice Guidelines (Parameters of care and position papers Hand Searching Experts Your clinical judgment 12/10/2018 Dennis E. Lopatin, Ph.D.

Quality Control What is the “best” data on which to base my decisions? Experimental design Statistical considerations Intangibles Funding sources Conflict of interest Peer review Journal standing 12/10/2018 Dennis E. Lopatin, Ph.D.

Back to the focused question The Well-Built Clinical Question CEBM 12/10/2018 Dennis E. Lopatin, Ph.D.

In-Class Practice Create a scenario in small groups Develop a focused question Homework assignment 12/10/2018 Dennis E. Lopatin, Ph.D.