PEARL practitioner-investigators (P-Is) are conducting sound and credible clinical research, according to an evaluation of the PEARL Network conducted late last year by the National Institute of Dental and Craniofacial Research (NIDCR) of the National Institutes of Health (NIH)—the agency that awarded the seven-year grant that helped to establish PEARL and two other practice-based research networks, or PBRNs, in April 2005.
The review, which was intended to assess how PEARL was performing at the midpoint of the seven-year grant, was conducted by Dr. Sue Hamann, a science evaluation officer in the NIDCR Office of Science Policy & Analysis, who is responsible for evaluating programs funded by the NIDCR and who has an extensive background in developing and overseeing clinical research studies on behalf of industry.
Dr. Hamann's evaluation was based on site visits to 10 PEARL P-Is. She also met with PEARL Executive Committee members and clinical research associates to review PEARL Network research protocols and quality assurance procedures, and surveyed 19 P-Is at the 2008 PEARL annual meeting to assess their experiences with and attitudes toward clinical research. Similar reviews of the two other NIH-supported PBRNs were also conducted in 2008.
"My evaluation shows that PEARL is meeting the key objective of educating general dentists about clinical research practices," said Dr. Hamann. "PEARL's use of CRAs, or clinical research associates, has brought a superior level of expertise to the training process. The CRAs train the P-Is to follow the guidelines for Good Clinical Practice, an international ethical and
scientific quality standard for conducting, recording, and reporting clinical trials."
Dr. Hamann added that the use of CRAs represents a model approach to quality assurance that enables PEARL to meet its objective of conducting sound and credible research, and noted that 89 percent of the P-Is she surveyed agreed that their participation in PEARL introduced new standards or quality assurance to their practice. Dr. Hamann also said that PEARL's study manuals meet Good Clinical Practice guidelines, and she commended PEARL for the positive working relationship it has established with the institutional review board that must approve its research studies.
According to Dr. Hamann, many P-Is- have developed an appreciation for research, with 95 percent of those surveyed reporting that participation in clinical research promotes and builds their practice and facilitates critical reading of dental research literature, and 82 percent reporting an improvement in technical skills in the practice area they were researching.
Dr. Hamann also evaluated the impact of PEARL research on clinical practice. "When I asked P-Is involved in the deep caries treatment study how likely it is that they would change clinical practice as a result of the study, the average response was 3.5 on a scale of 1 to 5, with 5 indicating the highest likelihood of change. This suggests an evolution in attitudes in which the P-Is are becoming more open to questioning long-held treatment practices. I expect that we'll see changes to clinical practice as more research results are disseminated through publications and meeting presentations."
In summing up her findings, Dr. Hamann recalled that dental PBRNs were considered an experimental concept when the NIDCR established PEARL and its sister networks in 2005. "Although PBRNs had been successfully used by physicians to test medical treatment protocols, no one had ever before attempted to have dentists evaluate operative procedures according to established clinical research procedures in a private practice setting. Based on my evaluation, the NIDCR has concluded that practice-based research can be an effective tool for improving general dental practice."