Implementing Research Findings and Evidence-Based Interventions into Real-World D

描述(由申请人提供)：今天，很少有普通牙医执行循证(EB)治疗指南的建议，尽管存在相关指南。相反，牙医倾向于使用在他们的初级牙科教育中获得的诊断和治疗方法。这种对旧方法的依赖阻碍了将新研究转化为实践。我们研究计划的长期目标是促进研究结果和EB干预在执业牙医中的整合(R01)。这项提案(R21)的目标是了解执业牙医和辅助人员的行为(=识别信息障碍)，基于这些新获得的知识开发典型的信息学解决方案(=克服这些障碍)，并在有限的规模上部署这些解决方案(=仪器开发的初步研究)。这项研究的结果将帮助我们完善假设，确立可行性，并为后续研究(R01)提供必要的试点数据，以比较现实世界牙科实践环境中各种实施的有效性。拟议的申请有三个具体目标。在AIM1中，我们将通过向牙医展示患者的小插曲并采访他们关于当前的治疗方法、信息障碍以及这些障碍的解决方案，来确定实施研究结果和EB干预的信息障碍。在目标2中，我们将生成一份针对手头患者定制的信息学解决方案的综合清单，以支持将治疗指南整合到普通牙医的执业工作流程中。在目标3中，我们将在试点研究中将新开发的信息学解决方案原型部署到执业牙医，使我们能够开发一种工具来衡量各种实施的有效性。将对该工具进行理解和可用性、可靠性和效度测试。使用该仪器对研究参与者进行抽样，将使我们能够确定最终目标受众的样本框架。这项工作将解决ADA关于EB牙科的政策的第三步，即“专注于将系统审查的结果转化为从业者使用。”我们的研究计划将有助于下一代实践管理系统的开发。我们相信，我们开发的信息学解决方案将克服常见的信息障碍，并加速电子患者记录系统在牙科中的“有意义的使用”。我们预计，我们的解决方案也将有助于在类似的实践环境中利用整合EB指南的解决方案。

DESCRIPTION (provided by applicant): Today, few general dentists implement the recommendations of evidence-based (EB) treatment guidelines even though relevant guidelines exist. Instead, dentists tend to use diagnostic and treatment methods acquired during their primary dental education. This reliance on old methods impedes translation of new research into practice. The long-term goal of our program of research is to promote the integration of research findings and EB interventions among practicing dentists (R01). The objectives of this proposal (R21) are to understand the behavior of practicing dentists and ancillary staff (=identify information barriers), develop prototypical informatics solutions based on this newly gained knowledge (=overcome these barriers) and deploy these solutions on a limited scale (=pilot study for instrument development). Results from this research will help us to refine hypotheses, establish feasibility and provide pilot data necessary for a follow-up (R01) study to compare the effectiveness of various implementations in a real-world dental practice setting. The proposed application has three Specific Aims. In Aim1, we will identify information barriers to the implementation of research findings and EB interventions by presenting patient vignettes to dentists and by interviewing them about current treatment approaches, information barriers, and solutions to those barriers. In Aim 2, we will generate a comprehensive list of informatics solutions customized to the patient at hand to support the integration of treatment guidelines into the practice workflow of general dentists. In Aim 3, we will prototypically deploy the newly developed informatics solutions in a pilot study to practicing dentists, allowing us to develop an instrument for measuring the effectiveness of various implementations. The instrument will be tested for understanding and usability, reliability and validity. Using the instrument to sample study participants will allow us to determine the sample frame of the ultimate target audience. This work will address the third step of the ADA's policy on EB dentistry, which is "focused on translating the findings from systematic reviews for use by practitioners." Our program of research will contribute to the development of next-generation practice management systems. We believe that the informatics solutions we develop will overcome common information barriers and accelerate the advent of the "meaningful use" of electronic patient record systems in dentistry. We anticipate that our solutions will be useful in leveraging solutions for the integration of EB guidelines in similar practice settings as well.