Research design hierarchy: Strength of evidence in evidence-based dentistry

As practitioners, thinking critically about how we make clinical decisions is important. As educators, we should evaluate how to teach students to make clinical decisions. To make clinical decisions, and to practice modern dentistry and to educate the dental care professionals, the evidence-based dentistry forms an important asset. The cornerstone of evidence-based healthcare and health technology assessment is critical appraisal of the evidence underpinning a finding. The hierarchy of evidence includes several types of studies used to evaluate treatment effects, starting from case reports, observational studies, and randomized controlled trials (RCTs), the tip of which are systematic reviews, which constitute the highest level of evidence because they attempt to collect, combine, and report the best available evidence using systematic, transparent, and reproducible methodology. Clinicians are interested in the highest quality research report available to determine the best therapy for their patients. This article will assist in framing the questions and categorizing the best available evidence. A search was initiated to locate original research articles, review articles, and case reports pertaining to the key words: Evidence-based dentistry, hierarchy of evidence, ladder of evidence, research design hierarchy, strength of evidence. Electronic database was retrieved from PubMed , Google and Google Scholar to search and select keywords related to evidence-based medicine and dentistry. The keywords used were evidence based dentistry, research design hierarchy, evidence based practice, and strength of evidence. This article is the result of a literature study on evidence-based research design hierarchy. Clinical Relevance to Interdisciplinary Dentistry Evidence-based practice (EBP) is an interdisciplinary approach gaining ground after 1992; hence, its usefulness in any discipline is worth the attention. This article explores links between the state of academic and clinical training regarding interdisciplinary EBP and describes strategies to accelerate the translation of evidence across disciplines. This paper examines the concept of hierarchy of research design, barriers and challenges and applying evidence based dentistry in practice.