dentalcare CE682 PubMed Search Strategies Course Instructions

dentalcare CE682 PubMed Search Strategies Course

Strategies for Searching the Literature Using PubMed

• Course Author(s): Jane L. Forrest, EdD, BSDH; Syrene A. Miller, BA, MSW
• CE Credits: 2 hours
• Intended Audience: Dentists, Dental Hygienists, Dental Assistants, Dental Students, Dental Hygiene Students, Dental Assisting Students
• Date Course Online: 03/20/2024
• Last Revision Date: NA
• Course Expiration Date: 03/19/2027
• Cost: Free
• Method: Self-instructional
• AGD Subject Code(s): 130

Online Course: www.dentalcare.com/en-us/ce- courses/ce682

Disclaimers

• P&G is providing these resource materials to dental professionals. We do not own this content nor are we responsible for any material herein.
• Participants must always be aware of the hazards of using limited knowledge in integrating new techniques or procedures into their practice. Only sound evidence-based dentistry should be used in patient therapy.

Please Note:

• Louisiana Dentists: This course has been approved by the Louisiana State Board of Dentistry to fulfill the mandatory opioid management CE requirement.

Conflict of Interest Disclosure Statement

• Dr. Jane Forrest has done consulting work for P&G. She is a member of the P&G Oral Care Global Dental Hygiene Advisory Board.
• Ms. Miller reports no conflicts of interest associated with this course.

Introduction – Substance Use Disorders
This continuing education course is a follow up to the course, Evidence-Based Decision Making: Introduction and Formulating Good Clinical Questions. The primary learning objectives for this course are to increase your skills in conducting an efficient computerized search using PubMed to answer a specific clinical question, the second step of the Evidence-based process.

Overview

Finding relevant evidence to answer clinical questions requires conducting a focused search of the peer-reviewed professional literature. To assist professionals in keeping up with the literature and in making it possible to quickly find needed information without leaving your location, online access to MEDLINE, the premier scientific database provided by the National Library of Medicine, is available at no cost through PubMed. The purpose of this course is to outline the steps involved in conducting a PubMed search using the traditional comprehensive PubMed search mechanism, including the MeSH database to answer clinical questions. A case scenarios will demonstrate the application of the skills involved. To gain hands-on experience learning the skills, open a second window in your browser and complete each step as you read about it in the course.

Learning Objectives
Upon completion of this course, the dental professional should be able to:

• Identify key search terms using the components of a PICO question (Patient/Population Problem, Intervention, Comparison and Outcome).
• Navigate PubMed’s home page.
• Apply PubMed’s Filters and Advance Search Features in conducting an efficient search.
• Search the PubMed MeSH Database to find the correct indexing terms.
• Describe how to use Boolean operators (AND, OR and NOT) to combine search terms.
• Discuss how using the PubMed ‘Filters’ feature assists in finding the highest levels of evidence.
• Explain how to combine previous search queries using the Advanced Search History feature.
• Effectively use PubMed to find evidence to answer a question using the PubMed features including: MeSH, Boolean Operators, Filters, and the Advance Search History.

Structuring a PubMed Comprehensive Search Using a PICO Question
The first course, Evidence-Based Decision Making: Introduction and Formulating Good Clinical Questions,1 demonstrated how to construct
a PICO Question from a case scenario. The following is a brief review of the case, the PICO question and key terms that will be used to illustrate a comprehensive PubMed search.

Case Scenario

• Your new patient, Mr. Nathan Baker, is a 20-year old college student-athlete who has been swimming competitively since he was 12-years-old. His chief complaint is about the smooth, yellow areas near his gum line that he recently noticed. He wants to know what might be causing this and if there is anything he can do to fix and/or prevent it from getting worse. When reviewing his health history and behaviors, you learn that Nathan is a vegetarian, frequently snacking throughout the day on healthy fruits and vegetables. He also consumes sports drinks and an occasional energy drink with his hectic student/athlete schedule.

• Nathan currently uses a manual toothbrush right after every meal, flosses nightly, and uses whatever fluoride toothpaste is on sale when he goes to buy one. Since you suspect his chief complaint is due to erosion, you perform the Basic Erosive Wear Examination (BEWE),2 and calculate his BEWE score to be 10, indicating he is at medium risk for erosive wear.

• From Nathan’s assessment, we suspect the erosion is due to multiple risk factors including his diet and dietary habits, oral health regimen, and his competitive swimming. After discussing each of Nathan’s risk factors, he realizes that some of his habits are contributing to his oral health problem. He had always thought being a vegetarian was healthy and that it was good to brush right after meals. He did not know that his diet was acidic and eating too frequently could contribute to erosion.3,4 Nor did he realize that he should wait 1-2 hours before brushing his teeth after an acid exposure,5 or that as a competitive swimmer, if he is training in water with a pH lower than the optimal (7.2-8.0) he may be subject to further erosion.6

• You both agree on changes that he can make with his eating and oral care habits but realize there are some things that aren’t going to change – like the fact he is a competitive swimmer and plans to remain a vegetarian. He then asks you about the toothpaste he should be using. He asks you about Sensodyne Pronamel® (a sodium fluoride toothpaste with potassium nitrate), since he recently heard a TV commercial stating that it helps with erosion. You typically recommend a stannous fluoride toothpaste, like Crest Pro-Health, but are not sure which one will be more effective in preventing the initiation and further progression of dental erosion.

• To find the answer, you structure Nathan’s question following the PICO formula: “For a patient with erosive tooth wear (P), will Sensodyne Pronamel® (a sodium fluoride toothpaste with potassium nitrate) (I), as compared to Crest Pro Health (a stannous fluoride toothpaste) (C), be more effective in preventing the initiation of further erosive tooth wear (O)?”
  Key search terms are derived from the PICO components comprising the PICO question. In this case, they include the Intervention (I: sodium fluoride toothpaste with potassium nitrate or Sensodyne Pronamel), and the Comparison (C: stannous fluoride toothpaste or Crest Pro-Health toothpaste). In this specific example, including the Problem (P), erosive tooth wear, as part
  of the search will be important since the two different fluoride toothpastes may be compared for other reasons, e.g., occlusal or root caries, or dentinal hypersensitivity. Without including the P, which narrows the search to the specific problem, the search would include different answers/outcomes other than their comparison for tooth erosion. However, in general, the two main search terms are the I and C since you will want studies that compare the two to determine which is more effective. Next, identify any additional terms or phrases (synonyms) related to the already identified P, I, C, and O (See

• Table 1 – Mr. Baker’s PICO Worksheet). By generating these words, alternative key terms are identified that facilitate finding evidence to answer the question.

Understanding PubMed Key Features
After structuring a specific clinical question, the next step in the evidence- based process is finding the evidence through conducting an online search of the scientific literature.
As familiar as many dental professions have become in searching the Internet, most have not had a specific course on searching biomedical databases, such as PubMed. These require a basic understanding of the PubMed features, including the MeSH (Medical Subject Headings) database. All features can be used with a traditional PubMed Comprehensive search, which begins on the homepage.

PubMed Home Page
Understanding how PubMed is structured begins with its Home Page (Figure 1). Three important areas that are most often used include:

1. A Search Box where terms are entered for conducting a traditional or comprehensive PubMed search.
2. Links to using the MeSH Database, and the User Guide providing directions to using each of the features.
3. A link to the Advanced Search feature (below the Search Box).

PubMed is a free web based retrieval system developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine. It is part of the larger NCBI system known as Entrez. PubMed includes over 36 million citations from MEDLINE, which comprises the largest part of PubMed. PubMed includes links to full text articles through PubMed Central and to publisher web sites that offer full-text articles, however, there may be a fee to access the full text. As technology has advanced, so have improvements to PubMed. The latest version of PubMed includes more available resources than the former version, which is no longer available (referred to as Legacy). Some of the new resources include
“About PubMed” and the “User Guide,” both of which can be found on the homepage under Learn. These upgrades were made along with enhancements to the mobile version with 40% of users accessing PubMed from a mobile device.7

MeSH (Medical Subject Headings)
PubMed has an online User Guide (https://pubmed.ncbi.nlm.nih.gov/help/), which includes YouTube tutorials that walk through the steps of a search and explain each PubMed feature  and tool so users understand how to conduct a search and the language for how information on the database is indexed. For example, PubMed and MEDLINE use the MeSH (Medical Subject Headings), a controlled vocabulary thesaurus or indexing language, which allows there to be consistency in the key terms assigned to the articles indexed from journals. Each reference is associated with a set of MeSH terms that describe the content of the item.
The MeSH Database can be accessed from the PubMed home page (Figure 1). By opening this browser, a word(s) can be entered in the search box. Although when typing in ‘stannous fluoride’ a pull-down list of other terms appears, do not mistake these for MeSH terms (Figure 2). They are just terms others have typed in.

Click on Search and the MeSH indexing term(s) that is/are used appear (Figures 3). Next, click on Tin Fluorides since this appears to be the applicable term. Additional information is displayed related to subheadings, different entry terms, previous indexing and where the term is structured in the hierarchical “MeSH tree” (Figure 4). This is a helpful tool when an original search does not yield enough results. It will often provide additional terms related to a search, which may lead to more relevant information. For example, in searching for evidence on stannous fluoride, type in the term ‘stannous fluoride’ to determine if it is the correct MeSH term.
The results from using the MeSH Browser indicate that Tin Fluorides (vs. stannous fluoride) is the MeSH indexing term, however stannous fluoride is an entry term. If there were an inadequate number of citations then  according to the MeSH Tree, the search would need to be broadened using the term Fluorides – one level up from Tin Fluorides.

When conducting the same search using the term Sodium Fluoride, the term Sodium Fluoride is identified as the MeSH term. Again, if there were an inadequate number of citations then according to the MeSH Tree, the search would need to be broadened using the term Fluorides – one level up from Sodium Fluoride.

Understanding PubMed Advanced Search Features
The Advanced search feature includes the Search Builder using Boolean Operators and the Search History. A link to the User Guide is available on the upper right side of Advanced Search (Figure 5) and explains the Advanced search feature.

Boolean Operators
Boolean logic refers to relationships among search terms. Boolean operators limit results of a search by letting the user combine search terms or concepts. The three Boolean operators are the words “AND,” “OR,” and “NOT” and although PubMed states they should be capitalized, you may also retrieve the same citations not capitalizing them.8 The AND operator is used to retrieve results that contain the entered search terms in a citation. A search for “stannous fluoride toothpaste AND sodium fluoride and potassium nitrate toothpaste” will retrieve only citations that reference BOTH. The AND is the default operator used in PubMed, so if a Boolean operator is not specified between two or more terms, PubMed will automatically use AND between terms.8
The OR operator looks for citations that have at least one of the terms and combines them together in one result. The OR operator is used to combine articles on similar topics or broaden your search. A search for “tooth erosion OR tooth wear” will retrieve citations that reference at least one of the terms. The OR Boolean operator is helpful to use when there are synonyms, e.g., tooth erosion OR erosive tooth wear. The NOT operator excludes the retrieval of terms from your search results. Typing “dental erosion NOT dental caries” excludes results about dental caries that also cause enamel damage. However, if articles refer to how enamel damage can occur, the NOT Boolean operator could eliminate relevant citations. Of the 3 Boolean operators, be cautious about using NOT.
PubMed automatically processes Boolean connectors in a left to right sequence, so when using multiple Boolean operators with more than two terms it may be important to enclose terms in parentheses, (tooth erosion OR tooth wear) AND (stannous fluoride toothpaste) AND (sodium fluoride and potassium nitrate toothpaste). The terms inside the parentheses, which is referred to as nesting, will be processed as a unit and then incorporated into the overall strategy.
Boolean Operators can be used when typing in terms in the Search Box on the Home Page (Figure 1) and when using the Search Builder on the Advanced Search Page (Figure 6), which is accessed from the Home Page (found under the search box). Later you will see that Boolean Operators also can be used in performing a search using Clinical Queries.

Advanced Search Builder and Search History Feature
Another valuable tool for conducting an evidence-based search is the Advanced Search Builder, including the Search History feature. This allows you to view all the search strategies that have been run and their results. It also allows you to combine previous search queries using the Boolean operators with new search queries. PubMed may move a search statement number to the top of the History when it’s used again, so the search queries may appear to be out of numerical order. Note when combining searches, the terms do not need to be spelled out again. Instead of typing out tooth erosion OR tooth wear, just type the number of the search, e.g., #1 or #2. Please note, you MUST use the # sign before the actual number.
Using the Advanced Search Builder, you can see that the terms tooth erosion (#1) or erosive tooth wear (#2) were then combined (#3), which then was combined with stannous fluoride toothpaste (#4). This limited the number of citations found to 42 (#5). Next, a search for sodium fluoride and potassium nitrate toothpaste (#6) identified 33 citations. It then was combined with #3 to limit the findings to those related to tooth erosion/erosive tooth wear. The final step was combining searches #5 AND #7 to identify studies that included both types of fluoride toothpaste in relation to tooth erosion (#8). This resulted inretrieving 2 studies. By clicking on 2 under the column Items found, you can see the two studies (Figure 7b).

If none of these studies answers Nathan’s question, then the search needs to be expanded by using broader or more generic terms as mentioned earlier.
As you can see from this search, terms were searched individually prior to combining them. This allows the user to see exactly what results were obtained for each term. Skipping the search for individual terms prior to combining them can result in missing important citations.

Conducting a Traditional or Comprehensive Search and the Use of Filters
Without knowing about or using the MeSH or Advanced search features, the most common way of beginning a search is to type in the main search term, tooth erosion, on the Homepage (Figure 8).

Next click on Search to see the results, which result in finding 3483 citations (Figure 9a). To narrow these results to the most current and highest levels of evidence, use the filters that appear on the left-hand column .
Scanning down the column you have choices related to Text Availability, Article Type, Publication Dates, and Additional Features (Figure 9b ).
Clicking on Additional Features allows you
to check off other Article Types, i.e., Practice Guideline and Comment, which are not a default publication type. Some of the other Additional Filters include Species, Languages, Sex, and Age (Figure 9c).
By clicking on SHOW, it places Practice Guideline and Comment under Article Type (Figure 9d). If you had clicked on any of the options under any of the Additional Filters, they too would appear on the main page.
Of all the filters, perhaps the most important is Article Type since it allows you to search for studies by levels of evidence. Beginning with clicking on Practice Guideline, the highest level of evidence, the 3483 citations are narrowed to 5 (Figure 10), which is much more reasonable to review. However, notice that the most recent one, #1, was published in 2008.
If no Practice Guideline was identified or none of those found answer your question,  then re-run the search. First clear the filter by clicking on “Clear all” to remove its selection. Next, click on Meta-Analysis, the next highest level of evidence. In this case, 12 citations are identified (Figure 11). Again, it’s important to only click on one filter at a time so that you know what level of evidence you have found.

If no Meta-Analysis is found, then re-run the search again by clicking on “Clear all” to remove Meta-Analysis and click on Systematic Reviews, the next highest level. There are 32 for this search. Continue this process so that you are able to identify the highest levels of evidence that answers your question. For a review of levels of evidence and the hierarchy that exists to guide clinical decision making see Evidence-Based Decision Making: Introduction and Formulating Good Clinical Questions.1
If there had been a large number of citations, another option is to use the “Publication Date” filter to limit the findings to the past 5 or 10 years. Also, if focusing on a specific age group, click on Show additional features and select the appropriate age group (Figure 12).

Searching with PubMed Clinical Queries Another feature for answering clinical questions for busy professionals and students is PubMed Clinical Queries. Click on the link found on the Homepage under Find (Figure 1). The Clinical Queries feature (Figure 13) provides specialized searches using evidence- based filters to retrieve articles. The built-in evidence-based algorithms streamline the process of searching for clinically relevant articles.

Of the options on the Clinical Queries page, our focus is on using the main search box and the Clinical Study Categories. Special algorithms are designed to find relevant evidence under the each Category. The default category is Therapy, however by clicking on the drop-down menu, other Filters are found, such as Clinical Prediction Guides, Diagnosis, Etiology, and Prognosis
(Figure 14).
These can be searched with a broad or narrow focus (Figure 15). Broad is the default so by using the drop-down menu narrow can be selected.

Clinical Queries allows an individual with limited computer searching skills to find high levels of evidence by typing in a main topic or specific terms of interest. Using the same clinical  scenario, “tooth erosion OR erosive tooth wear” is typed into the search box (Figure 16a).

By changing the Scope to Narrow, one goes from over 1687 to only 226.
The abstracts found under the Clinical Study Categories use evidence-based search filters to find individual studies in the indicated category. The default settings are ‘Therapy’ under Category  and ‘Broad’ under Scope, since the majority
of questions asked fall under the category of therapy. The type of studies retrieved for this category and scope are randomized controlled trials. Since there were over a thousand, change the Scope to Narrow (Figure 16b) and this will reduce the number of citations. A Narrow, specific search will return the most relevant citations, although it may miss some.

Although there is no one correct way to conduct a search, how search terms are entered influences the results and the number of steps needed to refine the search.

Conclusion

• Finding evidence to answer clinical questions requires skills that many professional programs are just now incorporating into curriculum. Although there is no one “correct” way to conduct a search, knowing how databases are designed and their key features allows you to be more efficient in quickly identifying relevant articles that can be used in clinical decision-making. The more successful you are, the more likely you will continue to search for the scientific evidence when it’s needed.
• PubMed offers two searching strategies, each of which can be conducted very efficiently if users take the time to learn how to use the Filters and Advanced Search features. Individuals with limited experience using PubMed can be successful in finding useful information as they develop or refine their searching skills.
• Just as in learning any skill, practice in conducting searches is needed. Again, one suggestion to gain hands-on experience is to follow the case scenarios in this course by opening a second window in your browser and doing each step as you read about it in the course. Another suggestion is to print out the pdf file of the course and use it as a guide after completing the course.
• To gain a more in depth understanding of PubMed, access Learn and their Online Training at https://learn.nlm.nih.gov/documentation/training-packets/T0042010P/. These include Quick Tours, which are brief animated tutorials with audio and cover a wide range of topics. Also, several areas have YouTube videos (in English and Spanish, scroll down to the end
  of the page) demonstrating different features, such as using the Advance search feature.

Course Test Preview

To receive Continuing Education credit for this course, you must complete the online test. Please go to: www.dentalcare.com/en-us/ce-courses/ce682/start- test

1. Which 2 PICO components provide the primary searching terms?
   • Problem and Outcome
   • Intervention and Comparison
   • Intervention and Outcome
   • Comparison and Outcome
   • Problem and Intervention.
2. Which best describes PubMed?
   • A web based retrieval system part of the National Library of Medicine.
   • Provides free access to MEDLINE, the premiere scientific database.
   • Provides links to articles and other resources.
   • Includes over 50 million citations from MEDLINE.
   • A, B & C.
3. What area of the PubMed Homepage is used to initiate a comprehensive search?
   • Search Box
   • Feature Tabs
   • MeSH Database
   • Side Bar Links
   • Tutorials
4. Which of the following tools is used to identify the PubMed indexing language?
   • Boolean Operators
   • Limits
   • Clinical Queries
   • MeSH Database
   • History
5. What is the primary purpose of Boolean Operators?
   • To make sure the largest number of results is identified.
   • To make sure the least number of results is identified.
   • To limit results of a search by combining terms or concepts.
   • A and B.
   • B and C.
6. Which Boolean Operator is used to exclude terms from a search?
   • not
   • or
   • and
   • never
   • A and B.
7. Which Boolean Operator is used to include both terms in the search?
   • not
   • or
   • and
   • never
   • B and C.
8. Which Boolean Operator is used to include at least one of two terms in a search?
   • not
   • or
   • and
   • never
   • A and D.
9. All of the following characteristics describe the Search History Feature except:
   • Allows you to view all the search queries and results.
   • Allows you to combine previous search queries.
   • Does not require you to capitalize Boolean operators.
   • Requires you to write out search terms.
   • Requires using the # sign when combining searches.
10. Which PubMed feature allows you to limit the citations according to study type?
    • Filters
    • Preview/Index
    • History
    • Clipboard
    • Details
11. Which Filter option(s) are used to limit citations to find the highest level of evidence?
    • Languages
    • Species
    • Article Types
    • A and B
    • B and C
12. Which PubMed feature is used to identify search terms when the original term does not yield enough results?
    • Boolean Operators
    • Filters
    • Clinical Queries
    • History
    • MeSH Database
13. Which of the following Clinical Studies Categories on the PubMed Clinical Queries page is the default category?
    • Clinical Prediction Guides
    • Diagnosis
    • Etiology
    • Prognosis
    • Therapy
14. Which of the PubMed Clinical Queries options finds citations for individual randomized controlled trials?
    • Clinical Study Categories: Therapy and Broad scope
    • Clinical Study Categories: Therapy and Narrow scope
    • Systematic Reviews.
    • COVID-19 Articles.
    • A and B
15. Which of the following Clinical Studies Categories on the PubMed Clinical Queries page is the default Scope?
    • Broad scope
    • Narrow scope
    • A and B are equal in scope
    • A and B
16. In question #15, if too many citations are found, which Clinical Queries option should be used next?
    • Broad Scope
    • Narrow Scope
    • Article Types
    • Languages
    • Species
17. You are using the Article Type filter and have not found any Practice Guidelines. Which Article Type will provide you with the next highest level of evidence?
    • Books and Documents
    • Clinical Trial
    • Cohort Study
    • Meta-Analysis
    • Randomized Controlled Trial
18. Boolean Operators only can be used with a comprehensive PubMed Search.
    • True
    • False

References

1. Forrest JL, Kopiac LM. Evidence-Based Decision Making: Introduction and Formulating Good Clinical Questions. dentalcare.com. Accessed July 1, 2021.

2. Bartlett D, Ganss C, Lussi A. Basic Erosive Wear Examination (BEWE): a new scoring system for scientific and clinical needs. Clin Oral Investig. 2008 Mar;12 Suppl 1:S65-8. doi: 10.1007/s00784-
   007- 0181-5. Epub 2008 Jan 29.

3. Barbour ME, Lussi A. Erosion in Relation to Nutrition and the Environment – Erosive Tooth Wear. Lussi A, Ganss C (Ed). Monographs in oral science, 2014; 25: 143-54.

4. Staufenbiel I, Adam K, Deac A, et al. Influence of fruit consumption and fluoride application on the prevalence of caries and erosion in vegetarians–a controlled clinical trial. Eur J Clin Nutr. 2015 Oct;69(10):1156-60. doi: 10.1038/ejcn.2015.20. Epub 2015 Mar 18.

5. White DJ, Noble WH, West N. Managing Dental Erosion: Current Understanding and Future Directions. dentalcare.com. Accessed July 1, 2021.

6. Buczkowska-Radlińska J, Łagocka R, Kaczmarek W, et al. Prevalence of dental erosion in adolescent competitive swimmers exposed to gas-chlorinated swimming pool water. Clin Oral Investig. 2013 Mar;17(2):579-83. doi: 10.1007/s00784-012-0720-6. Epub 2012 Apr 3. Accessed July 1, 2021.

7. U.S. National Library of Medicine. About MEDLINE® and PubMed®: The Resources Guide. Accessed November 3, 2021.

8. National Library of Medicine. PubMed Tutorial, Building the Search, Understand and use Boolean Operators, Boolean Logic. Accessed July 1, 2021.

9. National Library of Medicine. PubMed Tutorial, Building the Search, Understand and use Boolean Operators, Boolean Logic, Nesting. Accessed July 1, 2021.

10. Forrest JL, Miller SA. EBDM in Action, Developing Competence in EB Practice. 2nd Edition, Cave Creek, AZ; 2020, p.64-65.

Additional Resources

• No Additional Resources Available

About the Authors
Jane L. Forrest, EdD, BSDH
Dr. Forrest is a Professor Emerita of Clinical Dentistry, Ostrow School of Dentistry of USC, Los Angeles, CA. She also is the Director of the National Center for Dental Hygiene Research and Practice, Inc. Dr. Forrest is an internationally recognized author and presenter on Evidence-Based Decision Making
(EBDM), receiving the 2017ADA/AADR EBD Accomplished Faculty Award. She also received the 2017 NJDHA Carol King Award for Advancing the Profession of Dental Hygiene and the 2021 Esther Wilkins Lifetime Achievement Award.

Dr. Forrest is the lead co-author on the book, EBDM in Action: Developing Competence in EB Practice and its companion, the Faculty Toolkit. She also has co-authored chapters on EBDM in Clinical Periodontology and Dental Hygiene Theory and Practice, and several article series on “how to” build skills in finding scientific evidence and apply it to decisions in clinical practice. Dr. Forrest has received federal funding for several grants including one to prepare faculty on how to integrate an evidence-based approach into curriculum.
Email: jforrest@usc.edu or jforrest@usc.edu

Syrene A. Miller, BA, MSW
Syrene Miller is the Project Manager for the National Center for Dental Hygiene Research & Practice. She is involved in developing curriculum materials for Faculty Development Institutes and teaching health professionals and educators how to integrate an evidence-based approach into practice and curricula. Syrene created the website, Evidence-Based Decision Making. She is currently a clinical instructor at Washington State University working with students on scholarly projects and evidence-based decision making.

Syrene has presented at national and international dental, dental hygiene and allied health conferences on Evidence Based Decision Making including as a faculty member in the pre-Conference workshop for the 1st International Conference on Evidence-Based Dentistry. Syrene is the co-author with Jane Forrest on EBDM journal publications and on textbook chapters, the last 4 editions of Clinical Periodontology (Newman, Takei and Carranza editors), the current editions of Dental Hygiene Theory and Practice (Darby & Walsh; and Bowen & Pieren editors). Ms. Miller also is the co-author of the new textbook, Evidence-Based Decision Making: A Translational Guide for Dental Professionals.
Email: syrenemiller@gmail.com

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References

• Strategies for Searching the Literature Using PubMed | Continuing Education Course | dentalcare.com
• PubMed® Online Training
• Evidence-based Decision Making: Introduction and Formulating Good Clinical Questions | Continuing Education Course | dentalcare.com
• Help - PubMed
• Evidence-based Decision Making: Introduction and Formulating Good Clinical Questions | Continuing Education Course | dentalcare.com
• Strategies for Searching the Literature Using PubMed | Continuing Education Course | dentalcare.com

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