PICO循证医学原则在牙体牙髓病科住院医师病例报告中的应用效果评价

Application effect of population/patient,intervention/exposure,comparison/control,and outcome principles based on evidence-based medicine in case reports of residents in operative dentistry and endodontics

目的分析PICO(population/patient,intervention/exposure,comparison/control,outcome)循证医学原则在牙体牙髓病科住院医师病例报告中的应用效果。方法将中山大学附属口腔医院牙体牙髓病科住院医师随机纳入试验组与对照组,每组28名。试验组由带教教师指导将观察对象、干预措施/暴露因素、对照、结局原则应用于病例报告准备,对照组由带教教师指导进行传统式病例报告。比较两组住院医师出科病例报告的语言表达能力、病例完整度、诊治方案的合理性和先进性,以及讨论的逻辑性和科学性,并对两组住院医师进行问卷调查。采用SPSS 24.0软件对数据进行描述统计、t检验和卡方分析。结果试验组的出科病例报告平均成绩明显高于对照组[(89.25±3.24)分vs.(86.32±3.55)分,t=3.23,P=0.002],主要得分点在于讨论的逻辑性和科学性[(27.25±0.16)分vs.(23.78±0.36)分,t=8.77,P<0.001]。问卷调查显示,试验组住院医师希望参加病例报告的频率明显提升(P=0.035)。结论应用PICO式循证医学原则有助于提高牙体牙髓病科住院医师病例报告的总体水平,提升其参与病例报告的积极性。

Objective To investigate the application effect of population/patient,intervention/exposure,comparison/control,and outcome(PICO)principles based on evidence-based medicine in case reports of residents in operative dentistry and endodontics.Methods A total of 56 residents in Department of Conservative Dentistry and Endodontics in Hospital of Stomatology,Sun Yat-sen University,were selected and randomly divided into experimental group and control group,with 28 residents in each group.The residents in the experimental group were guided by the teachers to apply PICO principles in preparing case reports,and those in the control group were guided by the teachers to prepare traditional case reports.The two groups were compared in terms of the language expression of case reports,the completeness of case records,the rationality and advancement of the diagnosis and treatment regimen,and the logicality and scientificity of discussion,and a questionnaire survey was performed for both groups.SPSS 24.0 software was used to perform the descriptive statistical analysis,the t-test,and the chi-square test.Results The experimental group had a significantly higher mean score of case report than the control group in department examination[(89.25±3.24)vs.(86.32±3.55),t=3.23,P=0.002],especially the score of the logicality and scientificity of discussion[(27.25±0.16)vs.(23.78±0.36),t=8.77,P<0.001].The questionnaire survey showed that the experimental group had a significant increase in the frequency of participating in case reports(P-0.035).Conclusions The application of PICO principles can enhance the overall quality of case reports by residents and improve their enthusiasm in participating in case reports in department of operative dentistry and endodontics.