RESUMEN

Less than one-quarter of oral health trials are registered in a public registry. However, no study has assessed the extent of study publication and selective outcome reporting bias in the field of oral health. We identified oral health trials registered between 2006 and 2016 in ClinicalTrials.gov. We assessed whether results of early discontinued trials, trials having an unknown status, and completed trials had been published and, among published trials, whether outcomes differed between the registered record and the corresponding publication. We included 1,399 trials, of which 81 (5.8%) were discontinued, 247 (17.7%) had an unknown status, and 1,071 (76.6%) were completed. The registration was prospective for 719 (51.9%) trials. Over half the registered trials were unpublished (n = 793, 56.7%). To explore the association between trials publication and characteristics of trials, we performed a multivariate logistic regression analysis. Trials conducted in the United States (P = 0.003) or Brazil (P < 0.001) were associated with increased odds of publication, whereas trials registered prospectively (P = 0.001) and industry-sponsored trials (P = 0.02) were associated with decreased odds. Among the 479 published trials with completed status, the primary outcomes of 215 (44.9%) articles differed from that registered. Major discrepancies consisted of the introduction of a new primary outcome in the published article (196 [91.2%]) and the transformation of a registered secondary outcome into a primary outcome (112 [52.1%]). In the remaining 264 (55.1%) trials, primary outcomes did not differ from that registered, but 141 (53.4%) had been registered retrospectively. Our study highlights the high rate of nonpublication and selective outcome reporting in the field of oral health. These results could alert sponsors, funders, authors of systematic reviews, and the oral health research community at large to combat the nondisclosure of trial results.

Asunto(s)

RESUMEN

Tobacco is a risk factor for many chronic diseases and is the leading cause of preventable death. In the same way, periodontal diseases are one of the main chronic inflammatory diseases. The significant positive association between smoking and a higher risk of periodontitis is not any more to show and it appears that if smoking would be eliminated in this population, the risk of periodontitis would be reduced by approximately 14 %. Thus, the management of smoking cessation as well as periodontal treatment have become a public health issue. Motivational interviewing is a method of communication to support the change of health behaviour. The periodontist is then in the first position to set up a motivational interview in conjunction with smoking cessation and periodontal therapy. The taking into account of the risk factors among which tobacco is a stake for the restoration and the maintenance of periodontal health. Published evidence suggests that smoking cessation interventions are effective, highlighting the need for behavioural support in periodontal care. Motivational interviewing becomes an important part of both periodontal and smoking treatment.

Le tabac est un facteur de risque commun à nombreuses maladies chroniques; c'est la première cause de mortalité évitable. Les maladies parodontales sont l'une des principales maladies inflammatoires chroniques. L'association du tabagisme à une augmentation du risque de parodontite est bien démontrée; on estime que si le tabagisme était éliminé dans cette population, le risque de parodontite serait réduit d'environ 14 %. La prise en charge du sevrage tabagique, comme du traitement parodontal, est devenue un enjeu de santé publique. L'entretien motivationnel est une approche psychologique visant à engager les personnes dans le changement de comportement en matière de santé. Le parodontiste a une position idéale pour mettre en place un entretien motivationnel visant conjointement le sevrage tabagique et la thérapeutique parodontale. La prise en compte des facteurs de risque, dont le tabac, est un enjeu pour la restauration et le maintien de la santé parodontale. Les données publiées suggèrent que les interventions pour la cessation du tabagisme sont efficaces, soulignant ainsi la nécessité d'un soutien comportemental dans les soins parodontaux. L'entretien motivationnel devient une part importante du traitement, à la fois parodontal et tabagique.

Asunto(s)

RESUMEN

While it has often been stated that prevalence of schizophrenia is the same around the world, many publications have shown this illness is twice more frequent in urban areas. Although many hypotheses have been proposed, the mechanisms explaining this phenomenon are still unknown. Besides potential biological explanations, a certain number of hypotheses emerging from social sciences have recently enriched the debate. This article reviews the literature related to this issue and describes the development of a research projects conducted in collaboration between the Institut of Geography at the University of Neuchâtel, the Department of Psychiatry at the Lausanne University and the Swiss branch of ISPS, a society promoting the psychological treatment of schizophrenia and other psychoses.

Asunto(s)