Dissemination & Implementation Research
Promotion of Social Interactions to Change Clinical Practice in Dentistry
This research is a follow-up to an exploratory project funded by the NIDCR and led by Heiko Spallek, DMD, PhD, MSBA (CIS). In that study, we investigated the behavior of practicing dentists and ancillary staff, developed prototypical informatics solutions based on new knowledge, and deployed these solutions (see http://projectreporter.nih.gov/project_info_description.cfm?aid=8333257). Based on our findings, Drs. Heiko Spallek and Tanja Bekhuis are planning a clinical trial to compare technology-facilitated peer-to-peer coaching and study group facilitation to traditional dissemination of guidelines. The long‑term goal of this research is to improve dissemination of research findings, implementation, and adherence to EB guidelines among practicing dentists.
Clinical Decision Support System to Improve Adherence to Clinical Guidelines
In collaboration with Brad Rindal, DDS, and the HealthPartners Institute for Education and Research, the Center submitted a planning proposal to the NIDCR to design a clinical trial. The trial will test whether a clinical decision support (CDS) system can improve adherence to a clinical guideline. The project titled “Computer Assisted Tobacco Intervention for Dental Providers” will modify two existing electronic dental record systems to generate recommendations for dentists and dental hygienists to give to their patients who smoke. We plan to establish the effectiveness of a tobacco-cessation intervention delivered by dental providers using an EHR-integrated CDS system.
Translational Research for Oral Health and Craniomaxillofacial Disorders
Bernard J. Costello, DMD, MD, is involved in the following studies:
Predictive Analysis of Growth Discrepancies and Deformities
In collaboration with the NIH/NIDCR, UCSF, and the University of Florida, this study aims to using 3D radiographic and photo imaging, as well as genetic analysis to understand and predict significant deformities in patients with dysmorphology of the craniofacial region. We also collaborate with investigators at the NIH Genetic Institute. Our aim is to refine the understanding of these deformities and identify additional candidate genes that affect disproportionate growth.
Development of Resources to Identify Clinical Patterns of Oral and Maxillofacial Disease Processes
We use COHRI data and engage clinical faculty in scholarly activity using this clinical data set. We utilize informatics resources to design and implement studies aimed at identifying risk factors for diseases such as infection, temporomandibular joint disorders, chronic facial pain, and pathology.
Personalized Oral Healthcare
In collaboration with Dr. Alexandre Vieira, we offer services of genetic analysis targeting specific problems such as clefts, craniofacial deformities, and pathology that may have a genetic basis. Our aim is to gain a better understanding of the biologic behavior and severity of the deformity or disease process. We use informatics to facilitate analysis and locate specific disorders that may benefit from higher-level genetic analysis.
Automating Translational Research Methods
Tanja Bekhuis, PhD, MS, MLIS, AHIP, leads the following studies:
Screening Nonrandomized Studies for Inclusion in Systematic Reviews of Evidence
The US National Library of Medicine, a major funder of biomedical informatics research, supports this investigation. We use natural language processing, machine learning, and text mining to develop methods for systematic reviewers. Specifically, we seek to reduce the workload associated with screening studies for eligibility. The methods we develop are generalizable to various research domains, including oral medicine. In general, this research promotes synthesis of biomedical evidence in scientific reports.
Development of Search Filters to Retrieve Prognostic Biomarker Studies
We recently developed a gold standard dataset with labels for prognostic biomarker studies of oral squamous cell carcinoma (OSCC). This dataset will be useful in developing search filters to retrieve prognostic biomarker studies of OSCC with good sensitivity and positive predictive value. After this pilot study is completed, we will develop a proposal for further research to demonstrate generalizability of filters for retrieving research reports about other head and neck diseases. To our knowledge, no validated filters exist for prognostic biomarker studies.
Development of a Prototype to Explore the Content of Research Articles
This is a Web-based, interactive prototype with various content views of a set of research articles. We include publicly available images, such as photomicrographs, when articles are open access. This tool can support both informationists who need to refine search strategies and researchers who want to explore subsets of retrieved research articles.
Robert Weyant, MS, DMD, DrPH, leads the following study:
Center members, Robert Weyant, Deborah Polk, have in development a research application to NIH in response to PAR-10-140 (Dissemination and Implementation Research in Health). The proposal, to be submitted in June provides for the first step in a program of research, that will use Fixsen’s Implementation Model (2005) as the conceptual model to guide the development of an approach to building infrastructure to disseminate and foster implementation of already-established, evidence-based diagnostic and treatment interventions for dental caries within a dental school clinical practice setting. The rationale for our proposal is that once we create an approach to building the infrastructure needed to improve implementation, we will be positioned to test this approach in intervention studies in our school and multiple dental schools throughout the country.
Workforce Development to Improve Care in Rural Areas
Two Center faculty member, Robert Weyant (PI) and Joseph Ambrosino have current funding through the Graduate School of Public Health’s Center for Health Policy to develop a policy proposal targeted at state policy makers to provide them with evidence-based strategies that will improve access to dental care in PA. These strategies include recommendations that will: increase the overall supply of dentists working in underserved regions; increase the supply of dental services through expanding the dental workforce; and changes in the public funding for dental care that will lead to a larger provider network.