RESEARCH

1. EVIDENCE BASED DENTISTRY ▪ RELATIVE RISK

RELATIVE RISK. Ratio of the risks for an event in the exposed
group / risks for an event in the unexposed group.
▪SAMPLINGS
RR = 1: Risk predictor is NOT ASSOCIATED with the disease.
RR > 1: Risk predictor is ASSOCIATED with an INCREASE risk
of disease.
RR < 1: Risk predictor is ASSOCIATED with a DECREASE risk
of disease.

𝐈𝐧𝐜𝐢𝐝𝐞𝐧𝐜𝐞 𝐫𝐚𝐭𝐞 𝐢𝐧 𝐞𝐱𝐩𝐨𝐬𝐞𝐝 𝐩𝐨𝐩𝐮𝐥𝐚𝐭𝐢𝐨𝐧

RISK RATIO (RR) =
𝐈𝐧𝐜𝐢𝐝𝐞𝐧𝐜𝐞 𝐫𝐚𝐭𝐞 𝐢𝐧 𝐮𝐧𝐞𝐱𝐩𝐨𝐬𝐞𝐝

▪ ODDS
ODDS. Exposed/Unexposed

S 𝐎𝐝𝐝𝐬 𝐨𝐟 𝐞𝐱𝐩𝐨𝐬𝐮𝐫𝐞 𝐢𝐧 𝐜𝐚𝐬𝐞𝐬 𝐀/𝐂

Odds Ratio (OR) =
𝐎𝐝𝐝𝐬 𝐨𝐟 𝐞𝐱𝐩𝐨𝐬𝐮𝐫𝐞 𝐢𝐧 𝐜𝐨𝐧𝐭𝐫𝐨𝐥𝐬 𝐁/𝐃

▪NULL HYPOTHESIS
NH. Proposes that there is no significant difference
between the outcomes of different groups.
▪ If the CI does not include zero (Null Hypothesis) the results
are statically significant and the NH CAN be rejected.
▪ If the CI does include zero (Null Hypothesis) the results are
not statically significant and the NH CAN’T be rejected.

▪ PICO
PICO. An acronym used to formulate clinical research
questions.
▪ P = Population, Patient, or Problem OR = 1: Exposure is NOT ASSOCIATE with the disease.
▪ I = Intervention RR > 1: Exposure is ASSOCIATED an INCREASED Odds of
▪ C = Comparison disease.
▪ O = Outcome RR < 1: Exposure is ASSOCIATED a Decreased Odds of
disease.
▪ PREVALENCE
PREVALENCE. Frequency of disease for the population.

𝐍𝐮𝐦𝐛𝐞𝐫 𝐨𝐟 𝐩𝐫𝐞𝐯𝐢𝐨𝐮𝐬𝐥𝐲 𝐝𝐢𝐬𝐞𝐚𝐬𝐞𝐝 𝐜𝐚𝐬𝐞𝐬 ▪ SIGNIFICANCE

Prevalence =
𝐓𝐨𝐭𝐚𝐥 𝐏𝐨𝐩𝐮𝐥𝐚𝐭𝐢𝐨𝐧 Statistical significance. Measure mathematically using P-
Values.

P-Value Lower than < 0.05 is considered Statically

Significant and the null hypothesis can be rejected.
▪ INCIDENCE. P-Value > 0.05 result is NOT statistically Significant
INCIDENCE. Rate of developing new diseases

𝐍𝐮𝐦𝐛𝐞𝐫 𝐨𝐟 𝐧𝐞𝐰 𝐜𝐚𝐬𝐞𝐬

INCIDENCE =
𝐓𝐨𝐭𝐚𝐥 𝐏𝐨𝐩𝐮𝐥𝐚𝐭𝐢𝐨𝐧

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▪ HIERARCHY OF SCIENTIFIC EVIDENCE ▪ TYPE OF BIAS
▪ Selection BIAS.
- Occurs when participants included in a study are not
representative of the target population.
- Involves errors in sampling and retaining participants.
- Sampling. Attrition, recruitment, and survivorship are
subsets of Selection Bias.

▪ Measurement BIAS.
- When there are systematic errors in how data is collected,
measured or classified.

▪ Performance BIAS.
- When there are differences in the care provided to
participants in different study groups other than the
intervention being studied.

▪ META ANALYSIS/SYSTEMATIC REVIEW ↑ ▪ Reporting BIAS.

Studies results from 2 or more published studies. - There is selective revealing or suppression of information
- Systematic Review. Collects and summarizes data that fits or results, such as only publishing positive findings while
into a specified category. negative or inconclusive results are ignored or withheld.
- Meta Analysis. Uses statistical methods to analyze the
results of all the gathered studies.
▪ NULL HYPOTHESIS
▪ RANDOMIZED CONTROL TRIALS (RCT) ↑
Studies 2 randomly assigned sample groups.

▪ NON-RANDOMIZED CLINICAL TRIALS ↑

Studies non-random sample of groups.

▪ COHORT STUDIES ↑
Studies a random sample form a healthy, at-risk population
and follows them over time.
- Prospective Cohort studies follow individuals over time.
- Retrospective Cohort studies collect info about individuals
past.
- Measure Incidence, uses relative risk.

▪ CASE CONTROL STUDIES. ↓

Studies a random sample selected based on presence or
absence of disease.
- Case group (People who had exposure) and control group
(People who didn’t have exposure)
- Uses odds ratios.

▪ CROSS SECTIONAL STUDIES. ↓

Studies a random sample (cross-section in time) from a
target population. Measure PREVALENCE.

▪ CASE STUDY ↓
Studies a single person, group, or situation involving a rare
condition.

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2. INTERPRETING GRAPHICAL DATA ▪ FLOREST PLOT.
- Used to summarize information from individual studies in
meta-analysis.
▪ INTERQUARTILE RANGE - If a confidence interval crosses the vertical line of
Difference between the first (Q1) and third (Q3) “No difference” (odds ratio or relative risk) the outcome is
quartiles and indicates how spread out the middle 50 % of not statistically significant.
the data set is.

* If the OR crosses the line of “No difference” usually set

in 1, result will be “Not statistically significant”

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3. BIOSTATISTICS ▪ MEASUREMENTS.

▪ Accuracy. Is the degree to which a measurement

▪ CONFIDENCE INTERVAL (CI)
represents the true value of an outcome.

* If the range contains 0 that means there’s a possibility,

that there’s 0 (zero) differences between our 2 study
groups this means that our result is “Not statistically
significant” meaning that we cannot reject our null
hypothesis*

▪ Precision. Measure of the consistency among a set of

results.
▪ Reliability. Measure of how likely it is that experiment will
produce the same results when repeated.
▪ SENSITIVITY AND SPECIFICITY ▪ Validity. Is the extent to which the study effectively
measures what it is designed to measure, or how well a
▪ Sensitivity (SE) Measures the accuracy of the test in dataset represent the phenomenon being assessed.
detecting disease.
▪ VALIDITY
SE = TP / (TP+FN) x 100
*High SE indicates low numbers of FN.

▪ Specificity (SP) Measures the accuracy of the test in

detecting health. (Absence of disease)

SP = TN / (TN + FP) x 100

*High SP indicates low numbers of FP.

▪ MEASURES OF CENTRAL TENDENCY

▪ Mean. Average of values in a data set, affected by

outliners.
𝐀𝐥𝐥 𝐨𝐟 𝐭𝐡𝐞 𝐯𝐚𝐥𝐮𝐞𝐬
Mean =
𝐓𝐨𝐭𝐚𝐥 𝐧𝐮𝐦𝐛𝐞𝐫 𝐨𝐟 𝐯𝐚𝐥𝐮𝐞𝐬

▪ Median. Middle score in a data set, least affected by

outliners.
MEDIAN = Order the data from smallest to largest

Odd = The median in the middle value.

Ex. 4,8,6,10,12 = 4,6,8,10,12 Median = 8.

Even = The median is the average of the 2 middles values.

Ex. 4,8,6,10 = 4,6,8,10 = 6+8/2 = 7 Median = 7.

▪ Mode. Most frequent value in a data set.

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▪ TYPES OF VARIABLES ▪ PREDICTIVE VALUES.

▪ ERROR

▪ SIGNIFICANCE

▪ RESEARCH NOTATION

▪ TYPE OF STATISTICS.

▪ Interferential Statistics. Uses data collected from a sample

population in an investigation to reach conclusions.

▪ Descriptive Statistics. Focuses on describing the data

within the given research sample. They don’t involve in
making conclusions.

▪ Probability. Refers to how likely an event is to occur, or

how likely a proposition is true.

▪ Replication. Is the process of repeating a study to

determinate the consistency of research results.

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 10. Cross Sectional and Longitudinal Studies. Both studies
▪ QUESTIONS. measure the association between variable and outcome.
11. Randomized Control Trials. Experimental Study.
1. Type of Bias involves error in sampling and retaining 12. Cohort Study. Measure using Relative Risk.
participants? Selection Bias 13. Case Control. Uses Odds Ratio.

2. Goal of Evidence-based dentistry? Improve the quality of 14. Evidence-Based Dentistry.

care for patients. The ADA as a combined approach to treating pt based on
the following foundations:
3. Boolean Operator. Is a word or symbol that is used to ▪ Relevant Scientific Evidence
modify an internet search result, usually to increase or ▪ Patient needs and preferences,
narrow desired results. ▪ Clinical expertise.

4. PICO example. 15. Required to calculate statistical significance? P-Value

16. P-Value. Represents the likelihood that the results are
due to chance.
17. Provides a temporal relationship between exposure a
disease. Cohort Studies.
18. Tracks a group of people over time to determine if a
certain exposure is associated with the development of a
particular outcome. Cohort Study

19. Sensitivity. True positives among people with the

disease.
20. Specificity. True negatives among people without the
disease.

21. Cross Sectional and Longitudinal. Measure Association.

22. Investigation in the Colorado Brown Stain. Was a public

health assessment. Collects and evaluate information
about hazardous substances.

23. Best study to minimizes bias? Randomized controlled.

24. Study type most impacted by recall bias. Case Control.

5. Follows the same sample or group of people over a 25. When conducting a research study on fluoride
period of time. Longitudinal Study. absorption, which factor would most significantly impact
the study’s accuracy? Failure in test sensitivity.
6. Observational studies where two groups with different
outcomes are compared to investigate previous exposure to 26. Type of bias is reduced via blinding of the outcome
risks. Case control Study. assessment? Detection Bias.

7. Analyze data from a population at a single point in time. 27. Best sampling to avoid selection Bias. Randomized.
Cross-Sectional Study
28. Box Plot. Descriptive Study, cross sectional.
8. Involve observing or analyzing subjects without
manipulating variables. Observational Study.

9. Clinical Trial Phases on a NEW drug.

▪ Phase II. Given a medium-sized group of 100-300 people.
▪ Phase III. Intervention is given to a large group of 1K-3K
people to confirm its effectiveness, monitor SE.
▪ Phase IV. Drug is approved by the FDA and made available
to the public.

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1. PREVALENCE. Cases of 1M from 2010-2019
2. COHORT STUDY. Gives temporal relation of
exposure and disease. Follow over the time.
3. RANDOMIZED CLINICAL TRIAL. Experimental study
4. RANDOMIZED SAMPLING. Best method to avoid
selection bias.
5. WHICH ONE IS DUE TO CHANCE? PROBABILITY VALUE (P
VALUE)
6. TYPE 2 ERROR. Correct formula for determining the
statistical power of a study.
7. FIELD STUDY. In the natural environment.
8. RANDOMIZED CONTROLLED TRIAL (RCT).
Highest evidence-based dentistry.
9. CASE CONTROL. Study with a group of disease and
compare with another group.
10. COHORT STUDY. Measure incidence.
11. FALSE NEGATIVE. Endo ice test fail in vital tooth.
12. FOREST PLOT. Meta Analysis.
13. SYSTEMATIC ERROR IN PTS SAMPLING AND
RETAINING. Selection Bias.
14. SPECIFICY. Ability of a test to identify those without the
disease (True negative rate)
15. BEST EVIDENCE. Systematic review of randomized trials.
16. WICH ONE IS DUE TO CHANGUE. P-Value
17. BETTER ABOUT CONFIDENCE INTERVAL. Narrower CI
18. PROSPECTIVE CLINICAL TRIAL. Type of cohort study.
19. EXPERIMENTAL STUDY. Randomized Clinical Trial.
20. DOUBLE BLINDING. Patients and the researcher don’t
know about the study.
21. MEASURE INCIDENCE. Cohort study
22. MOST EFFECTIVELY MINIMIZES BIAS. Randomized
Controlled.
23. SELECTION BIAS. Involves errors in sampling and
retaining participants.

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