The Impact of the Evidence-Based Clinical Decision Support Resource "UpToDate" on the Speed and Accuracy of Determining Drug-Drug-Interactions in a Dental Setting| A Randomized Crossover Controlled Pilot Trial

• Main Author: Dragan, Irina F.
• Language: EN
• Published: Tufts University School of Dental Medicine 2018
• Subjects: Information technology|Dentistry
• Online Access: http://pqdtopen.proquest.com/#viewpdf?dispub=10839656

<p> <b>Aim &amp; Hypothesis:</b> The aim of the study was to compare the time dental students need to answer questions about drug-drug interactions (DDI) when using the Evidence-Based Clinical Decision Support Resource (EBCDSR) UpToDate^&reg; to retrieve patient-critical information versus general internet access, during a preclinical session. We hypothesized that the dental students utilizing the UpToDate^&reg; would take less time to identify the correct DDIs and obtain higher examination scores, compared with the group with only internet access. </p><p> <b>Materials &amp; Methods:</b> The proposed study design was a randomized blinded crossover controlled pilot and each subject examined four computer-based virtual cases, during two study visits. In the first visit, one group assessed two cases presented in axiUm (Tufts University School of Dental Medicine&rsquo;s electronic health record system), using UpToDate^&reg; access and the other group, using their own electronic resources assessed other two cases with no UpToDate^&reg; access, and determined the DDI. At the second visit, after the ten days wash-out period, the cross-over took place. Each case was followed by three questions regarding the drug-drug interactions, focusing on the use of antibiotics, analgesics and local anesthetics. The mean time duration of the sessions conducted by each subject was captured and calculated. Chi-square tests were used for the statistical analysis of the examination scores. All statistical analyses were performed using SAS Version 9.2 (SAS Institute, Cary, NC). </p><p> <b>Results:</b> A total of 50 dental students presented for the first study visit and 44 dental students for the second study visit. The third year dental students utilizing the UpToDate^&reg; took a similar amount of time to identify the correct DDIs compared with the third year dental students with no UpToDate^&reg; access and only internet access (p-value = 0.429). Both groups obtained similar examination scores for all the questions related to antibiotics (p-value = 0.797), analgesics (p-value = 0.850) and local anesthetics (p-value = 0.850). </p><p> <b>Conclusions:</b> The current study has shown that UpToDate^&reg; can provide answers to clinical questions at the point of care in a timely manner, with a high level of student satisfaction. Future studies might involve a more seamless entry into EBCDSR&rsquo;s using &ldquo;Infobutton&rdquo; in the Electronic Health Record (EHR).</p><p>