scholarly journals Leveraging Electronic Dental Record Data for Clinical Research in the National Dental PBRN Practices

2020 ◽  
Vol 11 (02) ◽  
pp. 305-314 ◽  
Author(s):  
Thankam Paul Thyvalikakath ◽  
William D. Duncan ◽  
Zasim Siddiqui ◽  
Michelle LaPradd ◽  
George Eckert ◽  
...  
Keyword(s):  
Clinical Research ◽  
Small Group ◽  
Patient Characteristics ◽  
Research Network ◽  
Permanent Teeth ◽  
Data Completeness ◽  
Learning Health System ◽  
Practice Based Research ◽  
Dental Practices ◽  
Using Data

Abstract Objectives The aim of this study is to determine the feasibility of conducting clinical research using electronic dental record (EDR) data from U.S. solo and small-group general dental practices in the National Dental Practice-Based Research Network (network) and evaluate the data completeness and correctness before performing survival analyses of root canal treatment (RCT) and posterior composite restorations (PCR). Methods Ninety-nine network general dentistry practices that used Dentrix or EagleSoft EDR shared de-identified data of patients who received PCR and/or RCT on permanent teeth through October 31, 2015. We evaluated the data completeness and correctness, summarized practice, and patient characteristics and summarized the two treatments by tooth type and arch location. Results Eighty-two percent of practitioners were male, with a mean age of 49 and 22.4 years of clinical experience. The final dataset comprised 217,887 patients and 11,289,594 observations, with the observation period ranging from 0 to 37 years. Most patients (73%) were 18 to 64 years old; 56% were female. The data were nearly 100% complete. Eight percent of observations had incorrect data, such as incorrect tooth number or surface, primary teeth, supernumerary teeth, and tooth ranges, indicating multitooth procedures instead of PCR or RCT. Seventy-three percent of patients had dental insurance information; 27% lacked any insurance information. While gender was documented for all patients, race/ethnicity was missing in the dataset. Conclusion This study established the feasibility of using EDR data integrated from multiple distinct solo and small-group network practices for longitudinal studies to assess treatment outcomes. The results laid the groundwork for a learning health system that enables practitioners to learn about their patients' outcomes by using data from their own practice.

Temporal trends in surgical procedures for pediatric hydrocephalus: an analysis of the Hydrocephalus Clinical Research Network Core Data Project

2020 ◽  
pp. 1-8
Author(s):  
Mandeep S. Tamber ◽  
John R. W. Kestle ◽  
Ron W. Reeder ◽  
Richard Holubkov ◽  
Jessica Alvey ◽  
...  
Keyword(s):  
Clinical Research ◽  
Temporal Trends ◽  
Patient Characteristics ◽  
Research Network ◽  
Third Ventriculostomy ◽  
Study Cohort ◽  
Core Data ◽  
Pediatric Hydrocephalus ◽  
Short Period ◽  
New Procedures

OBJECTIVEAnalysis of temporal trends in patient populations and procedure types may provide important information regarding the evolution of hydrocephalus treatment. The purpose of this study was to use the Hydrocephalus Clinical Research Network’s Core Data Project to identify meaningful trends in patient characteristics and the surgical management of pediatric hydrocephalus over a 9-year period.METHODSThe Core Data Project prospectively collected patient and procedural data on the study cohort from 9 centers between 2008 and 2016. Logistic and Poisson regression were used to test for significant temporal trends in patient characteristics and new and revision hydrocephalus procedures.RESULTSThe authors analyzed 10,149 procedures in 5541 patients. New procedures for hydrocephalus (shunt or endoscopic third ventriculostomy [ETV]) decreased by 1.5%/year (95% CI −3.1%, +0.1%). During the study period, new shunt insertions decreased by 6.5%/year (95% CI −8.3%, −4.6%), whereas new ETV procedures increased by 12.5%/year (95% CI 9.3%, 15.7%). Revision procedures for hydrocephalus (shunt or ETV) decreased by 4.2%/year (95% CI −5.2%, −3.1%), driven largely by a decrease of 5.7%/year in shunt revisions (95% CI −6.8%, −4.6%). Concomitant with the observed increase in new ETV procedures was an increase in ETV revisions (13.4%/year, 95% CI 9.6%, 17.2%). Because revisions decreased at a faster rate than new procedures, the Revision Quotient (ratio of revisions to new procedures) for the Network decreased significantly over the study period (p = 0.0363). No temporal change was observed in the age or etiology characteristics of the cohort, although the proportion of patients with one or more complex chronic conditions significantly increased over time (p = 0.0007).CONCLUSIONSOver a relatively short period, important changes in hydrocephalus care have been observed. A significant temporal decrease in revision procedures amid the backdrop of a more modest change in new procedures appears to be the most notable finding and may be indicative of an improvement in the quality of surgical care for pediatric hydrocephalus. Further studies will be directed at elucidation of the possible drivers of the observed trends.

scholarly journals Sex differences in incidence of respiratory symptoms and management by general practitioners

2020 ◽  
Vol 37 (5) ◽  
pp. 631-636 ◽  
Author(s):  
Johanna M Groeneveld ◽  
Aranka V Ballering ◽  
Kees van Boven ◽  
Reinier P Akkermans ◽  
Tim C Olde Hartman ◽  
...  
Keyword(s):  
Sex Differences ◽  
Respiratory Symptoms ◽  
Research Network ◽  
Prescribe Medication ◽  
Lung Physiology ◽  
Episode Of Care ◽  
Care Processes ◽  
Practice Based Research ◽  
Using Data ◽  
Diagnostic Investigations

Abstract Background Differences between women and men play an important role in lung physiology and epidemiology of respiratory diseases, but also in the health care processes. Objective To analyse sex differences in patients encountering their general practitioner (GP) with respiratory symptoms with regard to incidence, GP’s management and final diagnoses. Methods Retrospective cohort study, using data of the Dutch Practice Based Research Network. All patients who encountered their GP from 01-07-2013 until 30-06-2018 with a new episode of care starting with a reason for encounter in the respiratory category (R) of the ICPC-2 classification were included (n = 16 773). Multi-level logistic regression was used to analyse influence of patients’ sex on management of GPs with adjustment for possible confounders. Results We found a significant higher incidence of respiratory symptoms in women than in men: 230/1000 patient years [95% confidence interval (CI) 227–232] and 186/1000 patient years (95% CI 183–189), respectively. When presenting with cough, GPs are more likely to perform physical examination [odds ratio (OR) 1.22; 95% CI 1.11–1.35] and diagnostic radiology (OR 1.25; 95% CI 1.08–1.44), but less likely to prescribe medication (OR 0.88; 95% CI 0.82–0.95) in men. When visiting the GP with dyspnoea, men more often undergo diagnostic imaging (OR 1.32; 95% CI 1.05–1.66) and are more often referred to a specialist (OR 1.35; 95% CI 1.13–1.62). Conclusions Women encounter their GP more frequently with respiratory symptoms than men and GPs perform more diagnostic investigations in men. We suggest more research in general practice focussing on sex differences and possible confounders.

scholarly journals Use of digital periodontal data to compare periodontal treatment outcomes in a practice-based research network (PBRN) – a proof of concept

2020 ◽  
Author(s):  
Stefanie Anna Peikert ◽  
Felix Mittelhamm ◽  
Eberhard Frisch ◽  
Kirstin Vach ◽  
Petra Ratka-Krüger ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Study Data ◽  
Periodontal Treatment ◽  
Research Network ◽  
Research Networks ◽  
Postgraduate Students ◽  
Supportive Periodontal Therapy ◽  
Study Centre ◽  
Practice Based Research ◽  
Dental Practices

Abstract Background: Scientific studies in dentistry are mainly conducted at universities. However, most patients are treated in dental practices, which differ in many ways from treatment at the university. Through the establishment of practice-based research networks, however, it is also possible to examine studies in a real-world setting in dental practices. For this reason the aim of this non-interventional, observational study was to develop and evaluate a digital procedure to access, extract and analyse recorded clinical data in practices to assess periodontal treatment outcomes.Methods: Participating periodontists were former or active postgraduate students of a master’s course in periodontics in Freiburg who routinely used a digital periodontal diagnostic program. All available stored periodontal patient charts were extracted, anonymized and digitally sent to the study centre.Results: In this study, data were collected from 6301 patients from 9 different practices. Information such as probing depth (PD), bleeding on probing (BOP), mobility, furcation and gingival attachment for 153163 teeth at first visit were successfully transferred to the study centre. During the average observational period of 9.77 years, only 2.8% of all teeth were lost. The number of visits was significantly negatively correlated with BOP (p<0.0001), and the number of BOP-positive sites was significantly correlated with deeper PDs (p<0.001).Conclusion: The presented procedure was able to gather a large amount of practice-based periodontal data, and thus this study may support practice-based research networks. The data indicate that systematic and supportive periodontal therapy is successful on a practice-based level.Trial registration: The study was internationally registered on 4 January 2017 in the German Clinical Trials Register (DRKS 00011448). https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00011448

scholarly journals Promoting learning health system feedback loops: Experience with a VA practice-based research network card study

Healthcare ◽  
2021 ◽  
Vol 8 ◽  
pp. 100484
Author(s):  
Rachel E. Golden ◽  
Ruth Klap ◽  
Diane V. Carney ◽  
Elizabeth M. Yano ◽  
Alison B. Hamilton ◽  
...  
Keyword(s):  
Health System ◽  
Feedback Loops ◽  
Research Network ◽  
Learning Health System ◽  
Practice Based Research

scholarly journals Factors Influencing Likelihood of Voice Therapy Attendance: Report from the CHEER Network

2016 ◽  
Vol 156 (3) ◽  
pp. 518-524 ◽  
Author(s):  
Stephanie Misono ◽  
Schelomo Marmor ◽  
Nelson Roy ◽  
Ted Mau ◽  
Seth M. Cohen
Keyword(s):  
Patient Characteristics ◽  
Cross Sectional Study ◽  
Research Network ◽  
Voice Therapy ◽  
Patient Counseling ◽  
Cross Sectional ◽  
Factors Associated ◽  
Factors Influencing ◽  
Patient Reported ◽  
Practice Based Research

Objective To identify factors associated with the likelihood of attending voice therapy among patients referred for it in the CHEER (Creating Healthcare Excellence through Education and Research) practice-based research network infrastructure. Study Design Prospectively enrolled cross-sectional study. Setting CHEER network of community and academic sites. Methods Data were collected on patient-reported demographics, voice-related diagnoses, voice-related handicap (Voice Handicap Index–10), likelihood of attending voice therapy (VT), and opinions on factors influencing likelihood of attending VT. The relationships between patient characteristics/opinions and likelihood of attending VT were investigated. Results A total of 170 patients with various voice-related diagnoses reported receiving a recommendation for VT. Of those, 85% indicated that they were likely to attend it, regardless of voice-related handicap severity. The most common factors influencing likelihood of VT attendance were insurance/copay, relief that it was not cancer, and travel. Those who were not likely to attend VT identified, as important factors, unclear potential improvement, not understanding the purpose of therapy, and concern that it would be too hard. In multivariate analysis, factors associated with greater likelihood of attending VT included shorter travel distance, age (40-59 years), and being seen in an academic practice. Conclusions Most patients reported plans to attend VT as recommended. Patients who intended to attend VT reported different considerations in their decision making from those who did not plan to attend. These findings may inform patient counseling and efforts to increase access to voice care.

scholarly journals Use of digital periodontal data to compare periodontal treatment outcomes in a practice-based research network (PBRN): a proof of concept

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Stefanie Anna Peikert ◽  
Felix Mittelhamm ◽  
Eberhard Frisch ◽  
Kirstin Vach ◽  
Petra Ratka-Krüger ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Study Data ◽  
Periodontal Treatment ◽  
Research Network ◽  
Research Networks ◽  
Postgraduate Students ◽  
Supportive Periodontal Therapy ◽  
Study Centre ◽  
Practice Based Research ◽  
Dental Practices

Abstract Background Scientific studies in dentistry are mainly conducted at universities. However, most patients are treated in dental practices, which differ in many ways from treatment at the university. Through the establishment of practice-based research networks, however, it is also possible to examine studies in a real-world setting in dental practices. For this reason the aim of this non-interventional, observational study was to develop and evaluate a digital procedure to access, extract and analyse recorded clinical data in practices to assess periodontal treatment outcomes. Methods Participating periodontists were former or active postgraduate students of a master’s course in periodontics in Freiburg who routinely used a digital periodontal diagnostic program. All available stored periodontal patient charts were extracted, anonymized and digitally sent to the study centre. Results In this study, data were collected from 6301 patients from 9 different practices. Information such as probing depth (PD), bleeding on probing (BOP), mobility, furcation and gingival attachment for 153,163 teeth at first visit were successfully transferred to the study centre. During the average observational period of 9.77 years, only 2.8% of all teeth were lost. The number of visits was significantly negatively correlated with BOP (p < 0.0001), and the number of BOP-positive sites was significantly correlated with deeper PDs (p < 0.001). Conclusion The presented procedure was able to gather a large amount of practice-based periodontal data, and thus this study may support practice-based research networks. The data indicate that systematic and supportive periodontal therapy is successful on a practice-based level. Trial registration The study was internationally registered on 4 January 2017 in the German Clinical Trials Register (DRKS 00011448). https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00011448

Longevity of direct restorations in Dutch dental practices. Descriptive study out of a practice based research network

2016 ◽  
Vol 46 ◽  
pp. 12-17 ◽  
Author(s):  
Mark Laske ◽  
Niek J.M. Opdam ◽  
Ewald M. Bronkhorst ◽  
Jozé C.C. Braspenning ◽  
Marie Charlotte D.N.J.M Huysmans
Keyword(s):  
Descriptive Study ◽  
Research Network ◽  
Practice Based Research ◽  
Dental Practices

scholarly journals Use of digital periodontal data to compare periodontal treatment outcomes in a practice-based research network (PBRN) – a proof of concept

2020 ◽  
Author(s):  
Stefanie Anna Peikert ◽  
Felix Mittelhamm ◽  
Eberhard Frisch ◽  
Kirstin Vach ◽  
Petra Ratka-Krüger ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Study Data ◽  
Periodontal Treatment ◽  
Research Network ◽  
Research Networks ◽  
Postgraduate Students ◽  
Supportive Periodontal Therapy ◽  
Study Centre ◽  
Practice Based Research ◽  
Dental Practices

Abstract Background: Scientific studies in dentistry are mainly conducted at universities. However, most patients are treated in dental practices, which differ in many ways from treatment at the university. Through the establishment of practice-based research networks, however, it is also possible to examine studies in a real-world setting in dental practices. For this reason the aim of this non-interventional, observational study was to develop and evaluate a digital procedure to access, extract and analyse recorded clinical data in practices to assess periodontal treatment outcomes.Methods: Participating periodontists were former or active postgraduate students of a master’s course in periodontics in Freiburg who routinely used a digital periodontal diagnostic program. All available stored periodontal patient charts were extracted, anonymized and digitally sent to the study centre.Results: In this study, data were collected from 6301 patients from 9 different practices. Information such as probing depth (PD), bleeding on probing (BOP), mobility, furcation and gingival attachment for 153163 teeth at first visit were successfully transferred to the study centre. During the average observational period of 9.77 years, only 2.8% of all teeth were lost. The number of visits was significantly negatively correlated with BOP (p<0.0001), and the number of BOP-positive sites was significantly correlated with deeper PDs (p<0.001).Conclusion: The presented procedure was able to gather a large amount of practice-based periodontal data, and thus this study may support practice-based research networks. The data indicate that systematic and supportive periodontal therapy is successful on a practice-based level.Trial registration: The study was internationally registered on 4 January 2017 in the German Clinical Trials Register (DRKS 00011448). https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00011448

scholarly journals CAUSES FOR EXTRACTION OF PERMANENT TEETH IN GENERAL DENTAL PRACTICES IN YEMEN

2019 ◽  
Author(s):  
Yahya Alhadi ◽  
Abubakr H Rassem ◽  
Hassan Abdulwahab Al-Shamahy ◽  
Khaled M Al-Ghaffari
Keyword(s):  
Dental Caries ◽  
Tooth Extraction ◽  
Patient Characteristics ◽  
T Test ◽  
Permanent Teeth ◽  
Age And Gender ◽  
Dental Clinics ◽  
Dental Practices ◽  
And Gender ◽  
One Year

The aim of this survey was to investigate the primary causes for extraction of permanent teeth, its correlations with age and gender, as well as identify the important predictors for dental caries in Sana'a University dental clinics in Sana'a city, Yemen. The study was conducted over a period of one year; its population consisted of 1,420 patients, aged 9–72 years, who underwent tooth extraction. There were 761(53.6%) male and 659 (46.4%) female patients. The frequency distribution was calculated using the t-test, ANOVA and t test for differences in mean number of extracted teeth and the logistic regression model to evaluate the variables associated with causes for tooth extraction. A total of 2,585 teeth were extracted from the 1,420 patients. The highest rate (23.1%) of extraction occurred for those 41–50 years old. Males comprised 53.6% of patients but had more teeth (1598, 61.8%) extracted than females (987, 38.2%).The rate of teeth extracted on the day of the survey per patient was 1.82±0.07 (2.1±0.1 in males and 1.5±0.05 in females). Tooth loss due to caries was 69%; periodontal disease was 28%; pre-prosthetic reasons were 1.9% and other reasons were 1.14%. There was a significant association between patient characteristics (age and gender) and number of teeth extracted in which the Mean±SD of extracted numbers were increase with increasing age and higher in male patients than in females (p<0.001). The most frequently extracted teeth were mandibular first and second molars (446, 17.3%), followed by maxillary premolars (415, 16.1%), while mandibular canines were least frequently extracted (87, 3.4%). In conclusion; dental caries and periodontal problems were the main causes for tooth extraction in Sana'a city, Yemen.  

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