The goal of PROH is to provide the research infrastructure for generating practical, timely information that can be used by dental practitioners to enhance the quality and effectiveness of oral health care delivered to the general public.
The PROH Network conducts clinical oral health research using practitioners from different regions in Oregon and Washington, operating within their own practices, in their own communities, and on their own diverse patient pools.
This cadre of well-trained dental professionals is capable of undertaking research to answer questions that arise during the every day practice of dentistry and to evaluate products, procedures and behaviors. Virtually any clinical research project can be performed.
Practice-based Research Networks (PBRNs) are an established mechanism to conduct clinical research in medicine. They have been in existence for several decades, and have been successfully employed to investigate a wide variety of relevant medical issues. However, PBRNs have not been a part of oral health clinical research. The Practice-based Research in Oral Health (PROH) network was established to address this deficiency.
Controlled clinical trials are conducted primarily in university settings under very closely managed conditions. This scenario imparts the necessary scientific rigor to ensure that results are attributable to the independent variables. It helps to ensure that the study outcomes provide accurate and precise information about a new treatment, material, or technique. These controlled clinical studies are most useful for determining the maximum potential of the treatment of interest.
However, clinical trials in the university setting do not duplicate how various procedures are performed in routine practice outside of this setting, and therefore do not provide information about the typical outcomes to be expected within a practice-based population of clinicians. This discrepancy can significantly affect conclusions regarding oral health care outcomes. The controlled clinical trials are very expensive, and typically too small to include enough members of varying populations. In addition, controlled clinical trials do not allow assessment of disease progression and treatment effects under the normal “in situ” conditions in which dentistry is routinely practiced.
Therefore, there is a need for practice-based clinical studies that can reach a large and diverse population, while maintaining an adequate level of control of the design and conduct of the study. This is the intent of PROH.
The Practice-based Research in Oral Health (PROH) Network has the infrastructure to perform a wide variety of oral health research studies in a diversity of practice settings across Oregon and southwest Washington. It is designed to address certain shortcomings of clinical research as it is currently carried out.
The PROH Network is practitioner-centric with the participating practitioners and investigators actively involved in generating project ideas, as well as conducting the studies.
We also have the expertise, not just in the School of Dentistry, but in the university at large, to make this project a success.
The Network provides great flexibility as to future directions for research. The existing infrastructure has sufficient numbers and a variety of practitioners and practice settings to conduct virtually any clinical research project. It also serves as a focus for outreach by the dental school, and provides opportunities for involvement of the dental school with practices in rural and/or underserved communities. To this end, PROH is actively engaged with the Oregon Rural Practice-based Research Network (ORPRN) to investigate projects of mutual interest.
An OHSU Center of Excellence in Clinical Research (COEHR) grant from the Oregon Opportunity fund demonstrates the institutional commitment to the PROH Network and endorses the importance of this approach to clinical research.
Additional support from the Austin Clinical Research Endowment is greatly appreciated and indicative of the excitement generated in the community by the concept of practice-based research.
Funding for future studies is being pursued from the National Institutes of Health, foundations and the dental manufacturing industry.
The PROH network is governed by a steering committee. It is comprised of private practitioners, OHSU School of Dentistry faculty and staff, and other OHSU faculty. The members of the steering committee are:
Mark Driver, DMD, Roseburg, Oregon
Mark Jensen, DMD, Bend, Oregon
Walt Manning, DMD, Albany, Oregon
George McCully, DMD, Eugene, Oregon
John Shurtz, DDS, Salem, Oregon
Lyle J. Fagnan, Director of Oregon Rural Practice-based Research Network
Cynthia Morris, Director of Oregon Human Investigations Program
OHSU School of Dentistry Faculty and Staff
Thomas J. Hilton
Jack L. Ferracane
Cindy G. Barnes