The Impact of the Evidence-Based Clinical Decision Support Resource "UpToDate" on the Speed and Accuracy of Determining Drug-Drug-Interactions in a Dental Setting: A Randomized Crossover Controlled Pilot Trial
Abstract: Aim & Hypothesis: The aim of the study was to compare the time dental students need to answer questions about drug-drug interactions (DDI) when using the Evidence-Based Clinical Decision Support Resource (EBCDSR) "UpToDate" to retrieve patient-critical information versus general internet access, during a preclinical session. We hypothesized that the dental students utilizing the "UpToDat... read moree" would take less time to identify the correct DDIs and obtain higher examination scores, compared with the group with only internet access. Materials & Methods: The proposed study design was a randomized blinded crossover controlled pilot and each subject examined four computer-based virtual cases, during two study visits. In the first visit, one group assessed two cases presented in axiUm (Tufts University School of Dental Medicine's electronic health record system), using "UpToDate" access and the other group, using their own electronic resources assessed other two cases with no "UpToDate" access, and determined the DDI. At the second visit, after the ten days wash-out period, the cross-over took place. Each case was followed by three questions regarding the drug-drug interactions, focusing on the use of antibiotics, analgesics and local anesthetics. The mean time duration of the sessions conducted by each subject was captured and calculated. Chi-square tests were used for the statistical analysis of the examination scores. All statistical analyses were performed using SAS Version 9.2 (SAS Institute, Cary, NC). Results: A total of 50 dental students presented for the first study visit and 44 dental students for the second study visit. The third year dental students utilizing the "UpToDate" took a similar amount of time to identify the correct DDIs compared with the third year dental students with no "UpToDate" access and only internet access (p-value=0.429). Both groups obtained similar examination scores for all the questions related to antibiotics (p-value=0.797), analgesics (p-value=0.850) and local anesthetics (p-value=0.850). Conclusions: The current study has shown that "UpToDate" can provide answers to clinical questions at the point of care in a timely manner, with a high level of student satisfaction. Future studies might involve a more seamless entry into EBCDSR's using "Infobutton" in the Electronic Health Record (EHR).
Thesis (M.S.)--Tufts University, 2015.
Submitted to the Dept. of Periodontology.
Advisor: Nadeem Karimbux.
Committee: Bjorn Steffensen, Paul Stark, and Michael Newman.
Keywords: Dentistry, and Educational technology.read less