Translational Systems Approach to Clinical Dental Research: A Primer for Precision and Personalized Oral Health in Resource-Constrained Settings

Authors

  • Henry Adeola

DOI:

https://doi.org/10.61172/ndj.v31i2.227

Keywords:

Clinical Dental Research, Translational Dental Research, Artificial Intelligence, Africa, Precision Oral Health, Systems Approach

Abstract

Resource-constrained regions such as sub-Saharan Africa urgently need to leverage innovative approaches to dental care provision and research, using available scarce resources. Even though a lot of clinical dental research has emerged in Africa, from the use of clinical dental samples (or data) and carried out by dental healthcare personnels, the principles of clinical dental research (CDR) and the embellishment of a translational dental research (TDR) pipeline is not widely used and considered. Neither has this principle trickled down to curriculum-integrated mechanisms at many academic dental schools on the continent. Equipping future dental professionals with robust clinical dental research skill need to be implemented in an integrated and systematized manner on the continent. It is therefore important to define the precise parameters of CDR and what it should entail, as well as what the exact purpose of carrying out such research should be. Furthermore, key concepts in TDR, as well as precision and personalized oral health (PPOH) need to be established, in the era of precision and omics-based dentistry. Hence, this paper discusses an integrative implementation framework and models for optimizing the use of TDR for cost effective CDR in resource-limited settings. We also proposed the utilization of a CDR and TDR model that uses a systems-oriented, multiscale integration of CDR, TDR and PPOH within the clinical dental practice settings, dental research environments, as well as incorporation of these concepts into the pedagogical curriculum of undergraduate and postgraduate dental training programs. Using the proposed integrative implementation framework for CDR and TDR in resource-constrained regions, it is envisaged that cost- and labour-effective practices will be instituted. Not least, effective incorporation of PPOH and one health into CDR and TRD will hopefully translate into beneficial global oral public health policies and systems reform in Africa.

References

Folke C, Polasky S, Rockström J, Galaz V, Westley F, Lamont M, et al. Our future in the Anthropocene biosphere. Ambio. 2021;50(4):834-69.

Nazarenko S, Kriaučiūnienė J, Šarauskienė D, Jakimavičius D. Patterns of Past and Future Droughts in Permanent Lowland Rivers. Water. 2022;14(1):71.

Shang Y, Li H, Zhang R. Effects of Pandemic Outbreak on Economies: Evidence From Business History Context. Front Public Health. 2021;9:632043.

Hempel S, Burke R, Hochman M, Thompson G, Brothers A, Shin J, et al. Allocation of scarce resources in a pandemic: rapid systematic review update of strategies for policymakers. J Clin Epidemiol. 2021;139:255-63.

Ghosh S. Time, scarcity, and abundance. Front Res Metr Anal. 2022;7:974706.

Fanning Z. "Socialization for Scarcity" in Emergency Management: Rethinking Assumptions of Resource Scarcity in Humanitarian Crises. Ann Glob Health. 2023;89(1):24.

Adam NA, Alarifi G. Innovation practices for survival of small and medium enterprises (SMEs) in the COVID-19 times: the role of external support. Journal of Innovation and Entrepreneurship. 2021;10(1):15.

Krithikadatta J. Research methodology in Dentistry: Part I - The essentials and relevance of research. J Conserv Dent. 2012;15(1):5-11.

Krithikadatta J, Valarmathi S. Research methodology in dentistry: Part II - The relevance of statistics in research. J Conserv Dent. 2012;15(3):206-13.

Mouradian W, Lee J, Wilentz J, Somerman M. A Perspective: Integrating Dental and Medical Research Improves Overall Health. Frontiers in Dental Medicine. 2021;2.

Mozersky J, McIntosh T, Walsh HA, Parsons MV, Goodman M, DuBois JM. Barriers and facilitators to qualitative data sharing in the United States: A survey of qualitative researchers. PLoS One. 2021;16(12):e0261719.

Farnum MA, Ashok M, Kowalski D, Du F, Mohanty L, Konstant P, et al. A cross-source, system-agnostic solution for clinical data review. Database (Oxford). 2019;2019.

NCI. National Institute of Health; [Available from: https://www.cancer.gov/publications/dictionaries/cancer-terms/def/clinical-research.

Durant RW, Legedza AT, Marcantonio ER, Freeman MB, Landon BE. Different types of distrust in clinical research among whites and African Americans. J Natl Med Assoc. 2011;103(2):123-30.

Warren RC, Shedlin MG, Alema-Mensah E, Obasaju C, Hodge DA. Clinical Trials Participation Among African Americans and the Ethics of Trust: Leadership Perspectives. J Healthc Sci Humanit. 2020;10(1):104-23.

Scharff DP, Mathews KJ, Jackson P, Hoffsuemmer J, Martin E, Edwards D. More than Tuskegee: understanding mistrust about research participation. J Health Care Poor Underserved. 2010;21(3):879-97.

Friesen LR, Williams KB. Attitudes and motivations regarding willingness to participate in dental clinical trials. Contemp Clin Trials Commun. 2016;2:85-90.

Manja V, Lakshminrusimha S. Epidemiology and Clinical Research Design, Part 1: Study Types. Neoreviews. 2014;15(12):e558-e69.

Barkan H. Statistics in clinical research: Important considerations. Ann Card Anaesth. 2015;18(1):74-82.

Hilden J, Habbema JD. The marriage of clinical trials and clinical decision science. Stat Med. 1990;9(11):1243-57.

Rahman H. Influence of Research on Health Policy and Clinical Practice. J Obstet Gynaecol India. 2017;67(5):319-23.

Engelman A, Case B, Meeks L, Fetters MD. Conducting health policy analysis in primary care research: turning clinical ideas into action. Fam Med Community Health. 2019;7(2):e000076.

Jones DG, Dias GJ, Mercer S, Zhang M, Nicholson HD. Clinical anatomy research in a research-driven anatomy department. Clin Anat. 2002;15(3):228-32.

Bielekova B, Vodovotz Y, An G, Hallenbeck J. How implementation of systems biology into clinical trials accelerates understanding of diseases. Front Neurol. 2014;5:102.

Robinson P, Bacon CM, Lim SJ, Shaaban AM, Brierley D, Lewis I, et al. Assessment of clinical trial protocols for pathology content using the SPIRIT-Path guidelines highlights areas for improvement. J Pathol Clin Res. 2022;8(5):411-21.

Duburs G, Neibecker D, Žarković N. Chemistry and personalized medicine - the research and development future of Europe. Croat Med J. 2012;53(4):291-3.

Rej R. Clinical chemistry through Clinical Chemistry: a journal timeline. Clin Chem. 2004;50(12):2415-58.

Wang A, Xiu X, Liu S, Qian Q, Wu S. Characteristics of Artificial Intelligence Clinical Trials in the Field of Healthcare: A Cross-Sectional Study on ClinicalTrials.gov. Int J Environ Res Public Health. 2022;19(20).

Busnatu Ș, Niculescu AG, Bolocan A, Petrescu GED, Păduraru DN, Năstasă I, et al. Clinical Applications of Artificial Intelligence-An Updated Overview. J Clin Med. 2022;11(8).

Bhatt A. Artificial intelligence in managing clinical trial design and conduct: Man and machine still on the learning curve? Perspect Clin Res. 2021;12(1):1-3.

Russ AL, Fairbanks RJ, Karsh BT, Militello LG, Saleem JJ, Wears RL. The science of human factors: separating fact from fiction. BMJ Qual Saf. 2013;22(10):802-8.

Katz M, Bosworth HB. Behavioral sciences in clinical practice. Einstein (Sao Paulo). 2016;14(1):vii-xiv.

Gillies K, Brehaut J, Coffey T, Duncan EM, Francis JJ, Hey SP, et al. How can behavioural science help us design better trials? Trials. 2021;22(1):882.

Kwizera R, Mande E, Omali D, Okurut S, Nabweyambo S, Nabatanzi R, et al. Translational research in Uganda: linking basic science to bedside medicine in a resource limited setting. Journal of Translational Medicine. 2021;19(1):76.

Meina L, Wenya Y, Feng Y, Tao D, Lulu Z. Awareness of and attitudes toward translational medicine among health personnel in hospitals in Shanghai, China. J Int Med Res. 2019;47(1):438-52.

Austin CP. Opportunities and challenges in translational science. Clinical and Translational Science. 2021;14(5):1629-47.

Vukotich CJ, editor Challenges of T3 and T4 Translational Research | Vukotich, Jr. | Journal of Research Practice2016.

Blumberg RS, Dittel B, Hafler D, von Herrath M, Nestle FO. Unraveling the autoimmune translational research process layer by layer. Nat Med. 2012;18(1):35-41.

Faggion CM, Jr. The (in)adequacy of translational research in dentistry. Eur J Oral Sci. 2020;128(2):103-9.

Davidson A. Translational research: what does it mean? Anesthesiology. 2011;115(5):909-11.

Westfall JM, Mold J, Fagnan L. Practice-based research--"Blue Highways" on the NIH roadmap. Jama. 2007;297(4):403-6.

Barkhordarian A, Pellionisz P, Dousti M, Lam V, Gleason L, Dousti M, et al. Assessment of risk of bias in translational science. Journal of Translational Medicine. 2013;11(1):184.

Rubio DM, Schoenbaum EE, Lee LS, Schteingart DE, Marantz PR, Anderson KE, et al. Defining translational research: implications for training. Acad Med. 2010;85(3):470-5.

Domecq JP, Prutsky G, Elraiyah T, Wang Z, Nabhan M, Shippee N, et al. Patient engagement in research: a systematic review. BMC Health Serv Res. 2014;14:89.

Boenink M, van der Scheer L, Garcia E, van der Burg S. Giving Voice to Patients: Developing a Discussion Method to Involve Patients in Translational Research. Nanoethics. 2018;12(3):181-97.

Nakao K. Translational science: Newly emerging science in biology and medicine - Lessons from translational research on the natriuretic peptide family and leptin. Proc Jpn Acad Ser B Phys Biol Sci. 2019;95(9):538-67.

Manohar PR. The Translational Framework of Ayurveda as a Knowledge System. Anc Sci Life. 2016;36(2):59-60.

Ioachimescu OC. Medicinae investigationis, quo vadis? J Investig Med. 2021;69(1):2-3.

Wichman C, Smith LM, Yu F. A framework for clinical and translational research in the era of rigor and reproducibility. J Clin Transl Sci. 2020;5(1):e31.

Kahn K, Ryan G, Beckett M, Taylor S, Berrebi C, Cho M, et al. Bridging the gap between basic science and clinical practice: a role for community clinicians. Implement Sci. 2011;6:34.

Zarbin M. What Constitutes Translational Research? Implications for the Scope of Translational Vision Science and Technology. Transl Vis Sci Technol. 2020;9(8):22.

Homolak J. Opportunities and risks of ChatGPT in medicine, science, and academic publishing: a modern Promethean dilemma. Croat Med J. 2023;64(1):1-3.

Sallam M. ChatGPT Utility in Healthcare Education, Research, and Practice: Systematic Review on the Promising Perspectives and Valid Concerns. Healthcare (Basel). 2023;11(6).

Khan RA, Jawaid M, Khan AR, Sajjad M. ChatGPT - Reshaping medical education and clinical management. Pak J Med Sci. 2023;39(2):605-7.

Xue VW, Lei P, Cho WC. The potential impact of ChatGPT in clinical and translational medicine. Clin Transl Med. 2023;13(3):e1216.

Wen J, Wang W. The future of ChatGPT in academic research and publishing: A commentary for clinical and translational medicine. Clin Transl Med. 2023;13(3):e1207.

Kim SG. Using ChatGPT for language editing in scientific articles. Maxillofac Plast Reconstr Surg. 2023;45(1):13.

Agrawal P, Nikhade P. Artificial Intelligence in Dentistry: Past, Present, and Future. Cureus. 2022;14(7):e27405.

Quazi S. Artificial intelligence and machine learning in precision and genomic medicine. Medical Oncology. 2022;39(8):120.

Finkelstein J, Zhang F, Levitin SA, Cappelli D. Using big data to promote precision oral health in the context of a learning healthcare system. J Public Health Dent. 2020;80 Suppl 1(Suppl 1):S43-s58.

Fischer AH, Jacobson KA, Rose J, Zeller R. Hematoxylin and eosin staining of tissue and cell sections. CSH Protoc. 2008;2008:pdb.prot4986.

Lahiani A, Klaiman E, Grimm O. Enabling Histopathological Annotations on Immunofluorescent Images through Virtualization of Hematoxylin and Eosin. J Pathol Inform. 2018;9:1.

Chan JK. The wonderful colors of the hematoxylin-eosin stain in diagnostic surgical pathology. Int J Surg Pathol. 2014;22(1):12-32.

Goetz LH, Schork NJ. Personalized medicine: motivation, challenges, and progress. Fertil Steril. 2018;109(6):952-63.

Delpierre C, Lefèvre T. Precision and personalized medicine: What their current definition says and silences about the model of health they promote. Implication for the development of personalized health. Front Sociol. 2023;8:1112159.

Strianese O, Rizzo F, Ciccarelli M, Galasso G, D'Agostino Y, Salvati A, et al. Precision and Personalized Medicine: How Genomic Approach Improves the Management of Cardiovascular and Neurodegenerative Disease. Genes (Basel). 2020;11(7).

Yuan B. What Personalized Medicine Humans Need and Way to It --also on the Practical Significance and Scientific Limitations of Precision Medicine. Pharmgenomics Pers Med. 2022;15:927-42.

Almabadi ES, Bauman A, Akhter R, Gugusheff J, Van Buskirk J, Sankey M, et al. The Effect of a Personalized Oral Health Education Program on Periodontal Health in an At-Risk Population: A Randomized Controlled Trial. Int J Environ Res Public Health. 2021;18(2).

Amato A. Personalized Oral and Dental Care. J Pers Med. 2023;13(1).

Reddy MS, Shetty SR, Vannala V. Embracing Personalized Medicine in Dentistry. J Pharm Bioallied Sci. 2019;11(Suppl 2):S92-s6.

Wingrove S. Why Personalized Oral Hygiene Technology Matters. Compend Contin Educ Dent. 2022;43(3):f1-f4.

Bărbulescu R, Ioan D, editors. Multi-scale and reduced modelling of biological systems. 2015 9th International Symposium on Advanced Topics in Electrical Engineering (ATEE); 2015 7-9 May 2015.

Walpole J, Papin JA, Peirce SM. Multiscale computational models of complex biological systems. Annu Rev Biomed Eng. 2013;15:137-54.

Najafi A, Bidkhori G, Bozorgmehr JH, Koch I, Masoudi-Nejad A. Genome scale modeling in systems biology: algorithms and resources. Curr Genomics. 2014;15(2):130-59.

Baroni de Carvalho R, Shick E, Dye BA. The One Health initiative and its importance to oral health. J Am Dent Assoc. 2023;154(3):187-90.

Williams L. One Health and dentistry. Gen Dent. 2015;63(5):20-2.

Linder D, Cardamone C, Cash SB, Castellot J, Kochevar D, Dhadwal S, et al. Development, implementation, and evaluation of a novel multidisciplinary one health course for university undergraduates. One Health. 2020;9:100121.

Morens DM, Breman JG, Calisher CH, Doherty PC, Hahn BH, Keusch GT, et al. The Origin of COVID-19 and Why It Matters. Am J Trop Med Hyg. 2020;103(3):955-9.

Alanagreh L, Alzoughool F, Atoum M. The Human Coronavirus Disease COVID-19: Its Origin, Characteristics, and Insights into Potential Drugs and Its Mechanisms. Pathogens. 2020;9(5).

Platto S, Xue T, Carafoli E. COVID19: an announced pandemic. Cell Death Dis. 2020;11(9):799.

Mahdy MAA, Younis W, Ewaida Z. An Overview of SARS-CoV-2 and Animal Infection. Front Vet Sci. 2020;7:596391.

Austin CP. Opportunities and challenges in translational science. Clin Transl Sci. 2021;14(5):1629-47.

Hostiuc S, Moldoveanu A, Dascălu MI, Unnthorsson R, Jóhannesson Ó I, Marcus I. Translational research-the need of a new bioethics approach. J Transl Med. 2016;14:16.

Adeola HA, Soyele OO, Adefuye AO, Jimoh SA, Butali A. Omics-based molecular techniques in oral pathology centred cancer: prospect and challenges in Africa. Cancer Cell Int. 2017;17:61.

Adeola HA, Adefuye A, Soyele O, Butali A. The dentist-scientist career pathway in Africa: opportunities and obstacles. Korean J Med Educ. 2018;30(3):189-98.

Farrugia P, Petrisor BA, Farrokhyar F, Bhandari M. Practical tips for surgical research: Research questions, hypotheses and objectives. Can J Surg. 2010;53(4):278-81.

Fandino W. Formulating a good research question: Pearls and pitfalls. Indian J Anaesth. 2019;63(8):611-6.

Hugo FN, Kassebaum NJ, Marcenes W, Bernabé E. Role of Dentistry in Global Health: Challenges and Research Priorities. J Dent Res. 2021;100(7):681-5.

Patrick DL, Lee RS, Nucci M, Grembowski D, Jolles CZ, Milgrom P. Reducing oral health disparities: a focus on social and cultural determinants. BMC Oral Health. 2006;6 Suppl 1(Suppl 1):S4.

Peres MA, Macpherson LMD, Weyant RJ, Daly B, Venturelli R, Mathur MR, et al. Oral diseases: a global public health challenge. Lancet. 2019;394(10194):249-60.

Petersen PE, Bourgeois D, Ogawa H, Estupinan-Day S, Ndiaye C. The global burden of oral diseases and risks to oral health. Bull World Health Organ. 2005;83(9):661-9.

Downloads

Published

2023-11-06

How to Cite

Translational Systems Approach to Clinical Dental Research: A Primer for Precision and Personalized Oral Health in Resource-Constrained Settings. (2023). Nigerian Dental Journal, 31(2). https://doi.org/10.61172/ndj.v31i2.227