OSRA^QMUL: a digital application for oral surgery risk assessment

Adherence to clinical guidelines is central to patient safety in oral surgery, yet guideline uptake in routine dental practice remains inconsistent. Traditional guideline formats, such as static PDF documents, can be difficult to navigate at the point of care. Digital decision-support tools may improve accessibility, efficiency and clinician confidence, but evidence specific to oral surgery is limited.

To evaluate whether the Oral Surgery Risk Assessment (OSRA) digital application improves usability, efficiency, perceived clinical impact and user satisfaction compared with conventional PDF-based guideline access.

A randomised crossover study was conducted among 30 participants from a single academic centre, including undergraduate dental students, junior dental surgeons (DFTs/DCTs) and senior clinicians. Participants used both the OSRA digital application and conventional PDF guidelines across standardised oral surgery clinical scenarios. Outcomes were assessed using a structured questionnaire covering usability, reliability and trust, efficiency and workflow, satisfaction and future use and perceived clinical impact, measured on five-point Likert scales. Paired comparisons were analysed using Wilcoxon signed-rank tests, with effect sizes reported. Qualitative free-text feedback was analysed thematically.

Across all domains, the OSRA application was consistently rated higher than PDF guidelines (all p < 0.05), with large to very large effect sizes (r = 0.55-0.75). The greatest differences were observed for efficiency and workflow (r = 0.75) and satisfaction and future use (r = 0.73). Participants reported reduced cognitive load, faster access to guidance and greater confidence in clinical decision making when using the app. Reliability analysis demonstrated excellent internal consistency for app-based ratings (Cronbach's α = 0.96). Qualitative feedback highlighted clarity, intuitive navigation and workflow integration as key strengths, alongside requests for enhanced transparency of evidence sources and expanded functionality.

In this pilot study, the OSRA digital application outperformed conventional PDF guidelines across all evaluated domains, suggesting that digital, point of care decision support tools can improve guideline accessibility, efficiency and user experience in oral surgery. With further development and validation, such tools have the potential to support safer, more consistent evidence-based clinical practice.