Evidence-Based Practice in Oral and Maxillofacial Surgery: Audit of 1 Training Center

Abstract

Purpose: To evaluate the proportion of evidence-based interventions in the field of oral and maxillofacial surgery in a regional training center. Patients and Methods: A prospective clinical audit was carried out within the discipline of Oral and Maxillofacial Surgery, University of Hong Kong in February 2004 for a period of 6 months to investigate the extent of evidence-based practice. Consecutive diagnosis and intervention pairs were identified and recorded through standardized charts in randomly selected clinical sessions. A corresponding literature search using Medline and the Cochrane Library was performed to identify best current evidence. Each pair was then analyzed and graded according to the best current evidence. Results: Of 500 cases, 273 were eligible for evaluation while the rest were excluded based on 4 defined exclusion criteria. A majority of interventions (n = 195, 71.4%) were found to be evidence-based. Seventy-eight (28.6%) interventions were found to be not evidence-based. Among the evidence, a majority (56.1%) was level 5 evidence, which are case series or systematic review/meta-analysis of case series, and 36% were level 3 or above, which are randomized control trial (RCT) (level 3), meta-analysis of RCTs (level 2), or systematic review of RCTs (level 1). There was no statistically significant difference in the proportion of evidence-based practice between specialists and trainees in oral and maxillofacial surgery who saw and treated patients. Conclusion: This study demonstrated that most interventions prescribed in this oral and maxillofacial surgery training center were evidence-based, and the proportion was comparable with that reported by other specialties. © 2007 American Association of Oral and Maxillofacial Surgeons.