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

描述（由申请人提供）：今天，即使存在相关指南，也很少有普通牙医实施循证（EB）治疗指南的建议。相反，牙医倾向于使用在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。我们研究项目的长期目标是促进研究成果和EB干预措施在执业牙医中的整合（R01）。本提案（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），根据新获得的知识开发原型信息学解决方案（=克服这些障碍），并在有限规模上部署这些解决方案（=仪器开发的试点研究）。本研究的结果将帮助我们完善假设，建立可行性，并为后续研究（R01）提供必要的试点数据，以比较在现实世界牙科实践环境中各种实施的有效性。拟议的应用程序有三个具体目标。在目标1中，我们将通过向牙医展示患者画像，并就目前的治疗方法、信息障碍和这些障碍的解决方案对他们进行采访，从而确定实施研究结果和EB干预措施的信息障碍。在目标2中，我们将生成针对患者定制的信息学解决方案的综合列表，以支持将治疗指南整合到普通牙医的实践工作流程中。在目标3中，我们将在一项针对执业牙医的试点研究中原型地部署新开发的信息学解决方案，使我们能够开发一种测量各种实施有效性的工具。将测试该仪器的理解性和可用性、可靠性和有效性。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。这项工作将解决美国牙医协会EB牙科政策的第三步，即“重点是将系统评价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发展。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，并加速电子病历系统在牙科领域的“有意义使用”。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解决方案整合EB指南。

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.