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How meta‐analytic evidence impacts clinical decision making in oral implantology: a Delphi opinion poll
Author(s) -
Pommer Bernhard,
Becker Kathrin,
Arnhart Christoph,
Fabian Ferenc,
Rathe Florian,
Stigler Robert G.
Publication year - 2016
Publication title -
clinical oral implants research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.407
H-Index - 161
eISSN - 1600-0501
pISSN - 0905-7161
DOI - 10.1111/clr.12528
Subject(s) - scientific evidence , delphi method , expert opinion , opinion leadership , psychology , delphi , german , medicine , evidence based medicine , dentistry , medical education , medline , public relations , political science , computer science , law , history , philosophy , archaeology , epistemology , artificial intelligence , intensive care medicine , operating system
Objectives To investigate the impact of meta‐analytic evidence in scientific literature on clinical decision making in the field of oral implantology. Methods A Delphi opinion poll was performed at the meeting of the “Next Generation” Committees of the Austrian, German and Swiss Societies for Implantology ( ÖGI , DGI and SGI ). First, the experts gave their opinion on 20 questions regarding routine implant treatment (uninformed decisions), then they were confronted with up‐to‐date Level I evidence from scientific literature on these topics and again asked to give their opinion (informed decisions) as well as to rate the available evidence as satisfactory or insufficient. Topics involved surgical issues, such as immediate implant placement, flapless surgery, tilted and short implants and bone substitute materials, as well as opinions on prosthodontic paradigms, such as immediate loading, abutment materials and platform switching. Results Compared to their uninformed decisions prior to confrontation with recent scientific literature, on average, 37% of experts (range: 15–50%) changed their opinion on the topic. When originally favoring one treatment alternative, less than half were still convinced after review of meta‐analytic evidence. Discrepancy between uninformed and informed decisions was significantly associated with insufficient evidence ( P = 0.014, 49% change of opinion vs. 26% on topics rated as sufficiently backed with evidence). Agreement regarding strength of evidence could be reached for eight topics (40%), in three issues toward sufficiency and in five issues toward lack of evidence. Conclusion Confrontation with literature results significantly changes clinical decisions of implantologists, particularly in cases of ambiguous or lacking meta‐analytic evidence.