Evidence-based practice in oral and maxillofacial surgery: audit of 1 training center

To evaluate the proportion of evidence-based interventions in the field of oral and maxillofacial surgery in a regional training center.

A prospective clinical audit was carried out within the discipline of Oral and Maxillofacial Surgery, University of Hong Kong in February 2004 for a period of 6 months to investigate the extent of evidence-based practice. Consecutive diagnosis and intervention pairs were identified and recorded through standardized charts in randomly selected clinical sessions. A corresponding literature search using Medline and the Cochrane Library was performed to identify best current evidence. Each pair was then analyzed and graded according to the best current evidence.

Of 500 cases, 273 were eligible for evaluation while the rest were excluded based on 4 defined exclusion criteria. A majority of interventions (n = 195, 71.4%) were found to be evidence-based. Seventy-eight (28.6%) interventions were found to be not evidence-based. Among the evidence, a majority (56.1%) was level 5 evidence, which are case series or systematic review/meta-analysis of case series, and 36% were level 3 or above, which are randomized control trial (RCT) (level 3), meta-analysis of RCTs (level 2), or systematic review of RCTs (level 1). There was no statistically significant difference in the proportion of evidence-based practice between specialists and trainees in oral and maxillofacial surgery who saw and treated patients.

This study demonstrated that most interventions prescribed in this oral and maxillofacial surgery training center were evidence-based, and the proportion was comparable with that reported by other specialties.