***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Aim The aim of this study was to determine whether an educational intervention delivered by a computer aided learning package improved the sensitivity and specificity of dentists ' restorative treatment decisions Method The study was a r and omised controlled study using a Solomon three-group design . Ninety-five dentists were r and omly allocated to the three study groups . One group of dentists read the radiographs pre and post an educational intervention , a second group read the radiographs once , after the intervention , and a third group read the radiographs twice , but received no intervention . On each occasion the dentists read 24 surfaces on each of 15 radiographs and made 360 decisions on how certain they were about restoring the tooth surface . Comparisons of mean sensitivity , specificity and areas under ROC curves were made within and between the study groups . Kappa values were used to assess changes in the level of agreement between dentists . Results There were no significant changes in sensitivity , specificity or area under ROC curves caused by the intervention . There was no evidence that the level of agreement between the dentists improved after the intervention . Conclusion A computer aided learning package had no effect on dentists ' treatment decision-making behaviour Objective To investigate the effectiveness and cost-effectiveness of different guideline implementation strategies , using the Scottish Intercollegiate Guidelines Network ( SIGN ) Guideline 42 ' Management of unerupted and impacted third molar teeth ' ( published 2000 ) as a model . Design A pragmatic , cluster RCT ( 2 × 2 factorial design ) .Subjects Sixty-three dental practice s across Scotl and . Clinical records of all 16—24-year-old patients over two , four-month periods in 1999 ( pre-intervention ) and 2000 ( post-intervention ) were search ed by a clinical research er blind to the intervention group . Data were also gathered on the costs of the interventions . Interventions Group 1 received a copy of SIGN 42 Guideline and had an opportunity to attend a postgraduate education course ( PGEC ) . In addition to this , group 2 received audit and feedback ( A and F ) . Group 3 received a computer aided learning ( CAL ) package . Group 4 received A and F and CAL.Principal outcome measurement The proportion of patients whose treatment complied with the guideline . Results The weighted t-test for A and F versus no A and F ( P=0.62 ) and CAL versus no CAL ( P=0.76 ) were not statistically significant . Given the effectiveness results ( no difference ) the cost effectiveness calculation became a cost-minimisation calculation . The minimum cost intervention in the trial consisted of providing general dental practitioners ( GDPs ) with guidelines and the option of attending PGEC courses . Routine data which subsequently became available showed a Scotl and -wide fall in extraction s prior to data collection . Conclusion In an environment in which pre-intervention compliance was unexpectedly high , neither CAL nor A and F increased the dentists ' compliance with the SIGN guideline compared with mailing of the guideline and the opportunity to attend a postgraduate course . The cost of the CAL arm of the trial was greater than the A and F arm . Further work is required to underst and dental professionals ' behaviour in response to guideline implementation strategies Overwhelming evidence shows the quality of reporting of r and omised controlled trials ( RCTs ) is not optimal . Without transparent reporting , readers can not judge the reliability and validity of trial findings nor extract information for systematic review s. Recent method ological analyses indicate that inadequate reporting and design are associated with biased estimates of treatment effects . Such systematic error is seriously damaging to RCTs , which are considered the gold st and ard for evaluating interventions because of their ability to minimise or avoid bias . A group of scientists and editors developed the CONSORT ( Consoli date d St and ards of Reporting Trials ) statement to improve the quality of reporting of RCTs . It was first published in 1996 and up date d in 2001 . The statement consists of a checklist and flow diagram that authors can use for reporting an RCT . Many leading medical journals and major international editorial groups have endorsed the CONSORT statement . The statement facilitates critical appraisal and interpretation of RCTs . During the 2001 CONSORT revision , it became clear that explanation and elaboration of the principles underlying the CONSORT statement would help investigators and others to write or appraise trial reports . A CONSORT explanation and elaboration article was published in 2001 alongside the 2001 version of the CONSORT statement . After an expert meeting in January 2007 , the CONSORT statement has been further revised and is published as the CONSORT 2010 Statement . This up date improves the wording and clarity of the previous checklist and incorporates recommendations related to topics that have only recently received recognition , such as selective outcome reporting bias . This explanatory and elaboration document-intended to enhance the use , underst and ing , and dissemination of the CONSORT statement-has also been extensively revised . It presents the meaning and rationale for each new and up date d checklist item providing examples of good reporting and , where possible , references to relevant empirical studies . Several examples of flow diagrams are included . The CONSORT 2010 Statement , this revised explanatory and elaboration document , and the associated website ( www.consort-statement.org ) should be helpful re sources to improve reporting of r and omised trials Objective To assess the effect of educational outreach visits on antibiotic prescribing for acute dental pain in primary care . Study design R and omised controlled trial ( RCT ) . Setting General dental practice s in four health authority areas in Wales . Subjects and methods General dental practitioners were recruited to the study and r and omly allocated to one of the three study groups ( control group , guideline group or intervention group ) . Following the intervention , practitioners completed a st and ardised question naire for each patient that presented with acute dental pain . Interventions The control group received no intervention . The guideline group received educational material by post . The intervention group received educational material by post and an academic detailing visit by a trained pharmacist . The educational material included evidence -based guidelines on prescribing for acute dental pain and patient information leaflets . Main outcome measures The number of antibiotic prescriptions issued to patients presenting with dental pain and the number of ' inappropriate ' antibiotic prescriptions . Antibiotics were considered to be inappropriate if the patient did not have symptoms indicative of spreading infection . Results A total of 1,497 completed question naires were received from 23 , 20 and 27 general dental practitioners in the control , guideline and intervention group respectively . Patients in the intervention group received significantly fewer antibiotic prescriptions than patients in the control group ( OR ( 95 % CI ) 0.63 ( 0.41 , 0.95 ) ) and significantly fewer inappropriate antibiotic prescriptions ( OR ( 95 % CI ) 0.33 ( 0.21 , 0.54 ) ) . However , antibiotic and inappropriate antibiotic prescribing were not significantly different in the guideline group compared to the control group ( OR ( 95 % CI ) 0.83 ( 0.55 , 1.21 ) and OR ( 95 % CI ) 0.82 ( 0.53 , 1.29 ) respectively ) . Conclusions Strategies based upon educational outreach visits may be successfully employed to rationalise antibiotic prescribing by dental practitioners Background Routine oral examination ( ROE ) refers to periodic monitoring of the general and oral health status of patients . In most developed Western countries a decreasing prevalence of oral diseases underpins the need for a more individualised approach in assigning individualised recall intervals for regular attendees instead of systematic fixed intervals . From a quality -of-care perspective , the effectiveness of the widespread prophylactic removal of m and ibular impacted asymptomatic third molars ( MIM ) in adolescents and adults is also question able . Data on the effectiveness of appropriate interventions to tackle such problems , and for promoting continuing professional development in oral health care are rare . Methods / design This study is a cluster r and omised controlled trial with groups of GDPs as the unit of r and omisation . The aim is to determine the effectiveness and efficiency of small group quality improvement on professional decision-making of general dental practitioners ( GDPs ) in daily practice . Six peer groups ( ' IQual-groups ' ) shall be r and omised either to the intervention arm I or arm II . Groups of GDPs allocated to either of these arms act as each other 's control group . An IQual peer group consists of eight to ten GDPs who meet in monthly structured sessions scheduled for discussion on practice -related topics . GDPs in both trial arms receive recently developed evidence -based clinical practice guidelines ( CPG ) on ROE or MIM . The implementation strategy consists of one interactive IQual group meeting of two to three hours . In addition , both groups of GDPs receive feedback on personal and group characteristics , and are invited to make use of web-based patient risk vignettes for further individual training on risk assessment policy . Reminders ( flow charts ) will be sent by mail several weeks after the meeting . The main outcome measure for the ROE intervention arm is the use and appropriateness of individualised risk assessment in assigning recall intervals , and for the MIM-intervention group the use and appropriateness of individualised m and ibular impacted third molar risk management .  Both groups act as each other 's control . Pre-intervention data will be collected in study months one through three . Post-intervention data collection will be performed after nine months AIM To test the hypothesis that an increased utilization of nickel-titanium rotary instrumentation ( NTRI ) by general dental practitioners will lead to an increased frequency of good quality root fillings . A second aim was to determine whether the educational format would exert influence on the quality . METHODOLOGY Dentists were assigned at r and om to three intervention groups : a 4-h lecture  ( L-group , n = 40 ) ; a 4-h lecture plus a full day h and s-on course  ( LH-group , n = 40 ) ; or a control group receiving no instruction ( n = 68 ) . The control group received education later on in the study . Radiographs of two root filled molar teeth per dentist were selected at r and om before the start of the education program and after a 6-month clinical learning period . Using length , seal and shape of root-fillings a 5-level variable was created . RESULTS The rate of good quality root fillings increased after the introduction of NTRI . Calculated over all types of roots the frequency of excellent ( score 1 ) root fillings increased from 31 % to 51 % ( P = 0.006 ) in the L-group and from 27 % to 47 % ( P = 0.016 ) in the LH-group . The frequency of low quality root-fillings ( score 5 ) dropped in the L-group from 22 % to 16 % ( P = 0.29 ) and in the LH-group from 13 % to 9 % ( P = 0.48 ) . No statistically significant difference was seen among the controls . CONCLUSIONS When NTRI technology replaced manual stainless steel techniques the rate of good quality root fillings increased . A significant drop in the rate of low quality root fillings was not found The objective of this study was twofold , namely to evaluate the effectiveness of a dental clinical practice guideline on the management of asymptomatic impacted lower third molars ( i ) on referral rates and ( ii ) on dentists ' change in knowledge . A two-arm cluster r and omized controlled trial , with pre- and post-test assessment s , was conducted . A guideline was implemented by multifaceted interventions ( i.e. feedback , reminders , and an interactive meeting ) . The effect was evaluated after 1 yr by repeating the baseline question naire and by monitoring the number of patients who were referred for removal of their asymptomatic impacted m and ibular third molars . Instruments were question naires for detecting changes in knowledge , patient records , and panoramic radiographs . The knowledge of dentists regarding asymptomatic m and ibular third molar management was found to increase significantly in the intervention group as compared to the control group . There was no statistically significant difference between the groups in guideline -consistent patient referral rates at the post-test assessment . It was concluded that the methodology employed for dissemination and implementation of a clinical practice guideline on asymptomatic m and ibular third molar management improves dentists ' knowledge on this topic and is effective in improving decision-making in simulated cases ; however , no clinical effect was demonstrated BACKGROUND Continuing education is incumbent upon dentists as health professionals , but its promotion may be required , particularly in order to ensure regular professional updating . Continuing professional development may be delivered in a variety of ways , and new strategies and techniques must be evaluated for effectiveness . AIM To evaluate the effectiveness of two interventions utilizing the philosophies and techniques of the discipline of Quality Improvement . METHOD A self- assessment instrument ( a manual ) for quality dental practice was developed using the Delphi technique . A r and omized , controlled trial of the interventions was conducted under field conditions for dental practice in Victoria , Australia . Dentists in Test Groups 1 and 2 completed the self- assessment manual , and received relevant references and their own scores for the manual in comparison with empirical st and ards . Dentists in Test Group 1 also attended a continuing education course on Quality Improvement . Dentists in Control Group 1 completed the manual only and received feedback of their scores . Dentists in Test Groups 1 and 2 , and in Control Group 1 completed the manual again after 1 year as a post-intervention follow-up . Dentists in Control Group 2 completed the manual only at 1 year . RESULTS The intervention involving  self- assessment , receipt of scores and references for the manual result ed in modest improvements in total scores for dentists after 1 year , although a response bias was apparent . CONCLUSION An effective method of facilitating change in quality dental practice was identified . Assessment of strategies and techniques for professional development of dentists should include observation of patterns of participation This study evaluated the effects of three modes of education on dentists '  knowledge , attitudes , and use of  pit and fissure sealants .  A r and omly 
    Output:
    
A black box combination of interventions was rigorously evaluated and showed moderate impact on patient care .
This finding suggests that multi method and multiphased CPD has potential for the greatest impact .