Background: With the COVID-19 pandemic, thousands of children had their dental care interrupted or postponed, generating a pent-up demand for primary care. To minimize the impact of this outage, information and communication technologies (ICT) could be an alternative. The aim of this study is to elucidate the impact of implementing the ICTs in primary dental care for children on resolving the pent-up demand for primary dental care to children in the national health system service (SUS) due to the COVID-19 pandemic. Methods: Different research strategies are being proposed to demonstrate such effect and extrapolating findings to a real-world context to guide further research, practice and policies: two clinical trials (one randomized controlled by the waiting list trial (RCT) and a before-and-after study), one simulation study to prospect trial results to a broader population and three economic evaluations using different effects. Children enrolled in a reference dental unit will be invited to participate in the before-and-after study for trials. The first 368 families will be randomized for the RCT to the intervention vs waiting list. All participants will receive the intervention, but the waiting list group will be assessed before the intervention is available for them. The intervention comprises standardized non-face-to-face primary dental care using the V4H platform. The problem-solving and the family's perception will be the primary outcomes set for the before-and-after study and RCT, respectively. They will be measured 2 weeks after randomization. Based on trial findings, we will develop theoretical models to estimate how the intervention could benefit the population included in the national health system. Three economic evaluations will be carried out considering different trial effects (cost-effectiveness analyses). A societal perspective and the pandemic time horizon will be considered. Possible social impact (inequalities) will also be explored. Discussion: This ongoing trial may be an essential contribution to clarify positive and negative aspects related to the use of technologies for non-face-to-face dental care for children. Trial products may bring relevant contributions to the pandemic context and the post-pandemic period. Potential benefits may be feasible to implement and preserve in the health system even in the post-pandemic period. Trial registration Clinicaltrials.gov registration NCT04798599 (registered March 2021).
Artificial intelligence (AI) has become a strategic technology for global health, with increasing relevance amid the climate emergency and persistent digital inequalities. This study examines how AI has been applied in Brazilian healthcare through a scoping review with an in-depth methodological synthesis, focusing on Transfer Learning (TL) and Federated Learning (FL) as approaches to address data scarcity, privacy, and technological dependence. We searched PubMed, SciELO, and the CNPq Theses and Dissertations Repository for peer-reviewed studies on AI applications in Brazil, screened titles using AI-assisted tools with manual validation, and analyzed thematic patterns across methodological and infrastructural dimensions. Among 349 studies retrieved, six explicitly used TL or FL. These techniques were frequently implemented through multi-country research consortia, demonstrating scalability and feasibility for collaborative model training under privacy constraints. However, they remain marginal in mainstream practice despite their ability to deploy AI solutions with limited computational resources while preserving data sovereignty. The findings indicate an emerging yet uneven integration of resource-aware AI in Brazil, underscoring its potential to advance equitable innovation and digital autonomy in health systems of the Global South.
Economic evaluations in Dentistry have been increasing in recent years. They are a relevant contribution if an economic issue exists. Knowing if a new intervention is an efficient way of allocating available (and scarce) resources (the concept of opportunity costs), a well-designed economic evaluation may be helpful. One option is to conduct a trial-based economic analysis, which extracts a considerable board of information from a trial. This approach produces a more controlled result since many sources of variations might be reduced. On the other hand, some aspects could not be predicted directly from the trial or even extrapolated. Thus, combining model-based analysis may be an idea. In this paper, we intended to discuss important aspects to be considered by researchers in further economic evaluations. This paper will be systematically divided into sessions related to the study design as time horizon and perspective, health effects, costs, and data analysis. In the end, we expect the reader could be able to plan a trial-based economic evaluation, which should be a careful, meticulous, quite laborious and especially transparent process.
Objectives: This manuscript provides novel insights about the potential use of social media (a Facebook page, the first strategic attempt by EviDent initiative) to share evidence-based dentistry content and empowerment strategies for professionals, using quantifiable usage metrics, besides exposing the strengths and weaknesses of this knowledge translation strategy. One year-long gathered metrics were analyzed to understand information about usage patterns. Results: Publications were potentially exposed to 4784 users, and subsequent interaction with the page occurred in 18% of cases. Users' involvement with page content was associated with the number of page visitors (P = .005). However, users' interaction with the page was not associated with the potential number of users that could have seen the page (P = .25). Even considering the users that approved the posts, only 7%, on average, interacted with the post's links. Although social media has effectively disseminated scientific content, our experience revealed the user's passivity in interacting with the content. We expect to overcome these barriers by developing a mobile app to offer a more interactive and dynamic interface associated with a more attractive format for posting, including images and infographics.
Background: Important evidence has been constantly produced and needs to be converted into practice. Professional consumption of such evidence may be a barrier to its implementation. Then, effective implementation of evidence-based interventions in clinical practice leans on the understanding of how professionals value attributes when choosing between options for dental care, permitting to guide this implementation process by maximizing strengthens and minimizing barriers related to that. Methods: This is part of a broader project investigating the potential of incorporating scientific evidence into clinical practice and public policy recommendations and guidelines, identifying strengths and barriers in such an implementation process. The present research protocol comprises a Discrete Choice Experiment (DCE) from the Brazilian oral health professionals’ perspective, aiming to assess how different factors are associated with professional decision-making in dental care, including the role of scientific evidence. Different choice sets will be developed, either focusing on understanding the role of scientific evidence in the professional decision-making process or on understanding specific attributes associated with different interventions recently tested in randomized clinical trials and available as newly produced scientific evidence to be used in clinical practice. Discussion: Translating research into practice usually requires time and effort. Shortening this process may be useful for faster incorporation into clinical practice and beneficial to the population. Understanding the context and professionals’ decision-making preferences is crucial to designing more effective implementation and/or educational initiatives. Ultimately, we expect to design an efficient implementation strategy that overcomes threats and potential opportunities identified during the DCEs, creating a customized structure for dental professionals. Trial registration: https://osf.io/bhncv.
BACKGROUND The use of and interest in social media by health professionals as a tool for being updated as well as interacting with new scientific evidence are a reality. OBJECTIVE This manuscript aims to describe the first impressions from the development and the implementation of a social media web page to share digested scientific evidence (evidence translated by professionals/scientists into a more straightforward way to clinicians). Besides, we aimed to expose strengths and weakness we observed for this approach. Finally, we present a manner to overcome possible barriers found when implementing the dissemination of evidence-based information to potential users (clinicians). METHODS An institutional Facebook web page was launched by some researchers from the Dental School of the University of São Paulo, aiming to share reliable scientific evidence and offer scientifically digested evidence to permit clinicians to get the reliable information in Pediatric Dentistry. Another purpose was to empower them to understand further how and why such evidence could be relevant to guide their clinical practice. We collected the web page metrics of usability: posts reach (potential views) and users’ involvement (approvals, clicks on posts, comments, and shares). The relationship between the magnitude of the post reach and users’ involvement was tested using Bootstrapping Quantile Regression analysis (x1000). Weakness and strengths related to this strategy using the Facebook page were identified, and solutions proposed to minimize identified barriers. RESULTS After one year, the number of followers on Facebook page reached 1,347. The publications were potentially exposed to 4,784 users, and subsequent interaction with the page occurred only in 18% of cases. Users’ involvement with page content was associated with the number of users that visit the page (P= .005). However, users’ interaction with the page was not associated with the potential number of users that could have seen the page. (P= .25; Coef=.04; 95%;CI= -0.03 to .12). Even considering the users that effectively approved the posts, only 7%, on average, interacted with the links available into the post to going deeper to the topic. CONCLUSIONS Although social media being effective to rapidly and globally disseminate scientific content, our experience revealed the user’s passivity of our Facebook page in interacting with links to access information beyond those scientifically digested by the initiative. We expect to overcome users’ passivity with the development of a mobile app with the same purpose of the Facebook page, but offering a more interactive and dynamic interface.