This glossary is designed to assist dental professionals and public policymakers in developing a common language for discussion of issues pertaining to evidence-based dental care.
Best Evidence
The highest level of evidence available represents the current best evidence for a specific clinical question. Based on a hierarchy of levels of evidence, systematic reviews of randomized controlled trials constitute the highest level of current best evidence, and expert opinion is lower-level evidence.
Case-Control Study
A clinical study that involves identifying subjects with a clinical condition (cases) and subjects free from the condition (controls), and investigating if the two groups have similar or different exposures to risk indicator(s) or factor(s) associated with the disease.
Case Series
A report on a series of patients with an outcome of interest. No control group is involved.
Clinical Protocol
A step-by-step decision-making tool that describes how a health condition is diagnosed and managed.
Cochrane Collaboration 
An international nonprofit organization that develops evidence-based systematic reviews on health care interventions.
Cohort Study
A clinical study that with two groups (cohorts) of subjects, one that did receive the exposure of interest and another that did not, and following these cohorts forward for the outcome of interest.
Comparison
An alternative treatment or control group.
Controlled Clinical Trial
A clinical study that uses the same design features of a randomized controlled clinical trial (see definition below), but, for reasons beyond the control of the investigators, the subjects are assigned using a non-random process into control or experimental groups.
Critical Appraisal
A process followed by the ADA's EBD experts to evaluate the strength and content of a systematic review. The process of critical appraisal results in a Critical Summary intended to focus on the clinical utility or application of the systematic review findings.
Critical Summary
The process of critical appraisal results in a Critical Summary, which focuses on the clinical utility or application of the systematic review findings
Crossover Study Design
The administration of two or more experimental therapies, one after the other in a specified or random order, to the same group of patients.
Cross-Sectional Study
The observation of a defined population at a single point in time or in a specified time interval. Exposure and outcome are determined simultaneously.
Evidence-Based Clinical Recommendations
Recommendations developed through critical evaluation of the collective body of evidence on a particular topic to provide practical applications of scientific information that can assist dentists in clinical decision-making. The strength of the recommendation is classified according to the existing level of evidence . An example of evidence-based clinical recommendations is the ADA Evidence-Based Clinical Recommendations on Professionally Applied Topical Fluoride .
Evidence-Based Dentistry
An approach to oral health care that requires the judicious integration of systematic assessments of clinically relevant scientific evidence, relating to the patient's oral and medical condition and history, with the dentist's clinical expertise and the patient's treatment needs and preferences.
Evidence-Based Medicine
The conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients. The practice of evidence-based medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research.
Intervention
A diagnostic test or procedure, prescribed therapy, or other action intended to detect, prevent or treat a health condition.
Levels of Evidence
Hierarchical rating systems used to grade individual or multiple studies based on type of study design and effectiveness in answering a specific research question. Evidence levels follow a structured hierarchy of criteria for grading strength of evidence, and some include assessment of the study’s methodological quality, precision of statistical data for the population being studied (internal validity), and other considerations.
MEDLINE™
The National Library of Medicine's searchable database of over 12 million indexed citations from more than 4,600 medical, dental, health and scientific journals. Additional information is available through the ADA Library.
Meta-Analysis
A review that uses quantitative methods to combine the statistical measures from two or more studies and generates a weighted average of the effect of an intervention, degree of association between a risk factor and a disease, or accuracy of a diagnostic test.
Outcome
Measures used to assess effects of an intervention or exposure.
PICO (or PECO)
An acronym used to identify four primary components of a well-formulated clinical question: “Patient Population or Problem ” (P), “Intervention or Exposure” (I/E), “Comparison” (C), and “Outcome” (O).
Population
Individuals or groups for whom an answer is sought.
Probability of Success
A ratio of the number of patients who benefit from an intervention to all those who receive an intervention. A probability figure, such as 0.5 or 50%, means that out of 100 patients, 50 would benefit from an intervention and 50 would not benefit. Neither the dentist nor the patient can determine beforehand to which of the two groups a patient will belong.
PubMed
The National Library of Medicine’s free-access Web site for searching the MEDLINE database. For more information, visit this online tutorial .
Randomized Controlled Clinical Trial
A clinical study in which participants are randomly (i.e., by chance) assigned to either an experimental group or control group. The experimental group receives the new intervention and the control group receives a placebo or standard intervention. These groups are followed up for the outcomes of interest.
Systematic Review
A process of systematically locating, appraising and synthesizing evidence from scientific studies in order to obtain a reliable overview. The aim is to ensure a review process that is comprehensive and unbiased. Findings from systematic reviews may be used for decision-making about research and the provision of health care.
Some of the definitions are based on information provided in the glossary of the Oxford Centre for Evidence-Based Medicine (http://www.cebm.net/glossary.asp ).
Additional Resources and Glossaries:
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