Change in Stated Practice Associated with Participation in “The Dental-PBRN”

Objective: To test the hypothesis that participation in a dental practice-based research network (PBRN) is associated with significant changes in stated clinical practice and intention to change it. Researchers have attempted many methods to translate scientific evidence into routine practice, with varying success. "The Dental PBRN” (DPBRN) is a consortium of dental practices and organizations that comprises five regions: Alabama/Mississippi; Florida/Georgia; HealthPartners and private practitioners in Minnesota; Permanente Dental Associates in cooperation with Kaiser Permanente Center for Health Research; and Scandinavia. Methods: DPBRN dentist practitioner-investigators completed a detailed questionnaire about how they diagnose and treat dental caries (available at www.DentalPBRN.org). Next, the 133 practitioner-investigators who registered for DPBRN's first network-wide meeting of all five regions received a customized report that compared their answers to answers from all other practitioner-investigators. Then, 126 attended the network-wide meeting. Certain questions were repeated and new ones were asked about intention to change how they diagnose or treat dental caries. Key meeting objectives were to present: (1) an organized venue for collegial interaction; (2) results from two DPBRN studies about caries diagnosis and treatment; (3) latest evidence from the literature about caries diagnosis, prevention, and treatment. Panel discussions, question-and-answer sessions, informal gatherings, and formal breakout groups were organized. Each group formally presented its findings and conclusions. Results: Less than one-third (30%) of practitioner-investigators intended to change how they diagnose or treat caries as a result of receiving the customized report. However, as a result of the meeting, the majority stated an intention to change diagnosis (59%) or treatment (82%) toward a more-conservative, less surgically-invasive, approach. These percentages varied significantly (p<0.05) by DPBRN region. Conclusion: These findings suggest that the highly-interactive meeting with fellow practitioner-investigators may be an effective means to translate scientific findings into clinical practice. Support: U01-DE-16746, U01-DE-16747.