Concordance between clinical practice and published evidence: findings from The National Dental Practice-Based Research Network

J Am Dent Assoc. 2014 Jan;145(1):22-31. doi: 10.14219/jada.2013.21.


Background: Documenting the gap between what is occurring in clinical practice and what published research findings suggest should be happening is an important step toward improving care. The authors conducted a study to quantify the concordance between clinical practice and published evidence across preventive, diagnostic and treatment procedures among a sample of dentists in The National Dental Practice-Based Research Network ("the network").

Methods: Network dentists completed one questionnaire about their demographic characteristics and another about how they treat patients across 12 scenarios/clinical practice behaviors. The authors coded responses to each scenario/clinical practice behavior as consistent ("1") or inconsistent ("0") with published evidence, summed the coded responses and divided the sum by the number of total responses to create an overall concordance score. The overall concordance score was calculated as the mean percentage of responses that were consistent with published evidence.

Results: The authors limited analyses to participants in the United States (N = 591). The study results show a mean concordance at the practitioner level of 62 percent (SD = 18 percent); procedure-specific concordance ranged from 8 to 100 percent. Affiliation with a large group practice, being a female practitioner and having received a dental degree before 1990 were independently associated with high concordance (≥ 75 percent).

Conclusion: Dentists reported a medium-range concordance between practice and published evidence.

Practical implications: Efforts to bring research findings into routine practice are needed.

Keywords: Clinical practice; dentistry; evidence-based dentistry; implementation science.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Data Collection
  • Dental Caries / diagnosis
  • Dental Caries / therapy
  • Dental Restoration, Permanent / methods
  • Dental Restoration, Permanent / statistics & numerical data
  • Evidence-Based Dentistry / statistics & numerical data*
  • Guideline Adherence / statistics & numerical data
  • Humans
  • Molar, Third / surgery
  • Practice Patterns, Dentists' / standards*
  • Practice Patterns, Dentists' / statistics & numerical data
  • Surveys and Questionnaires
  • Tooth Extraction / statistics & numerical data
  • United States / epidemiology