Alonso Carrasco-Labra, DDS, MSc, PhD

Alonso Carrasco-Labra, DDS, MSc, PhD
Associate professor at the Department of Preventive and Restorative Sciences
Director, Cochrane Oral Health Collaborating Center
University of Pennsylvania School of Dental Medicine
9:30 a.m. 
Friday, March 1, 2024
International Academy of Endodontics, Annual Meeting
The Rosen Plaza Hotel
Orlando, Florida, USA
“Creation of trustworthy and context-specific evidence-based clinical practice guidelines."
Evidence-based clinical practice guidelines are systematically developed healthcare recommendations that assist patients, practitioners, and caregivers make decisions about appropriate healthcare for specific clinical circumstances. They integrate the best available research evidence with clinical expertise and patient values and preferences, which leads to improved patient outcomes, consistency in care, and efficient use of resources. Key features of a trustworthy guideline include:
  1. Rigorous Development: Trustworthy guidelines are developed through a rigorous process involving systematic syntheses of the evidence and assessing the benefits and harms of alternative care options.
  2. Transparency: Reliable guidelines document their development process, including how evidence is gathered and evaluated. They disclose conflicts of interest among the guideline developers and establish explicit mechanisms to minimize the impact of those interests.
  3. Multidisciplinary Panel: The involvement of a diverse group, including general practitioners, researchers, specialists, patient partners, government,  and other relevant stakeholders, ensures that different perspectives are addressed.
  4. Evidence-Based Recommendations: Trustworthy guidelines base their recommendations on a careful review of the current evidence, clearly linking their statement to the underlying evidence, including an assessment of the certainty of the evidence and a transparent process for moving from the evidence to the decisions. 
  5. Regular Updates: They are regularly updated to reflect new evidence, ensuring the guidance remains current and relevant.
  6. Clear Presentation: Recommendations are presented clearly and precisely, making them accessible and actionable for practitioners and other stakeholders.
Major Topics:
  1. Evidence-based clinical practice guidelines.
  2. Determination of balance between benefits and harms.
  3. Utilization of patients' values and preferences in decision-making.
  4. Determinants of a trustworthy guideline.
Learning Objectives: 
  1. Understand the Fundamentals of Evidence-Based Clinical Practice Guidelines: To grasp the basic concepts and importance of evidence-based clinical practice guidelines in healthcare.
  2. Identify the Components of Trustworthy Guidelines: To learn the key elements that make a clinical practice guideline trustworthy, including transparency, evidence basis, management of conflict of interest, and rigor in development.
  3. Recognize the Role of Multidisciplinary Panels: To appreciate the importance of involving a diverse group of stakeholders, including practitioners, patient partners, and specialists, in the guideline development process.
Affiliations:  I do not have a financial conflict of interest concerning this presentation. However, I have several intellectual conflicts of interest: I am a member of the GRADE working group, the Director of the newly founded Cochrane Oral Health Collaborating Center at the University of Pennsylvania School of Dental Medicine, and a member of the Cochrane Patient-reported Outcome Methods Group.
About the Presenter:  Dr. Alonso Carrasco-Labra is an associate professor at the Department of Preventive and Restorative Sciences and the Center for Integrative Global Oral Health at the School of Dental Medicine, University of Pennsylvania. He is also the Director of the new Cochrane Oral Health Collaborating Center at Penn Dental Medicine. He is a dentist with a master’s in clinical epidemiology and a Ph.D. in health research methodology from McMaster University (Canada). He led the Department of Evidence Synthesis & Translation Research at the American Dental Association Science and Research Institute (ADASRI).

With extensive experience as a clinical practice guideline and policy methodologist, he has worked with various organizations such as the Pan-American Health Organization/World Health Organization (PAHO), the World Bank, the U.S. Food and Drug Administration (FDA), the American Gastroenterological Association (AGA), and the American Dental Association (ADA). He has formally trained WHO/PAHO staff on conducting systematic reviews and guidelines. He has also served as a guideline and policy methodologist for various countries such as Saudi Arabia, the Dominican Republic, Canada, Peru, Colombia, Spain, and Chile, among others. His published works include more than 140 articles in peer-reviewed journals in medicine and dentistry, as well as ten books and handbooks focused on evidence-based medicine and research, including the highly regarded "Users' Guide to the Medical Literature" (3rd edition), published by the Journal of the American Medical Association (JAMA), the book “How to Use Evidence-Based Dental Practices to Improve Your Clinical Decision-Making” published by the American Dental Association in 2020, and the Cochrane Handbook for conducting systematic reviews.
He has closely collaborated in creating two national-level guideline programs and formally evaluated and improved the implementation of guideline recommendations for the Chilean Ministry of Health, using grant funding from the World Health Organization. As a member of the GRADE working group, he has contributed to refining the GRADE approach. He has conducted more than 16 guidelines and more than 40 systematic reviews and meta-analyses associated with those guidelines.

In 2020, he received the IADR William J. Gies award for the best clinical article published in the Journal of Dental Research titled “Nonrestorative Treatments for Caries: Systematic Review and Network Meta-analysis,” which made it to the list of the most cited articles in the journal in the last three years and has been used to inform policy and practice worldwide.