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Sipiyaruk K, Santiwong P, Sommaluan K, Mokkasak S, Rachuratchata C, Rattanaopas T. The implementation of PROMs/PREMs in the assessment of orthodontic treatment outcomes: A questionnaire survey. J Int Soc Prev Community Dent 2022; 12:210-215. [PMID: 35462744 PMCID: PMC9022384 DOI: 10.4103/jispcd.jispcd_275_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 10/14/2021] [Accepted: 11/12/2021] [Indexed: 11/30/2022] Open
Abstract
Objectives: The aim of this study was to explore the impact of self-perceived treatment outcomes and experiences on psychological aspects, reflecting the importance of patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) in orthodontic practice. Materials and Methods: A questionnaire was constructed using the PROMs/PREMs concepts. It contained five parts: “Demographic data”, “Self-perceived esthetics”, “Self-perceived functional concern”, “Satisfaction of treatment procedures”, and “Psychological aspect”. The questionnaire was piloted in five experts and 50 orthodontic patients to ensure its quality, using content validity, test-retest reliability, and Cronbach’s alpha. The validated version was provided to patients who had a complete fixed appliance orthodontic treatment. These data were analyzed using descriptive statistics, Mann-Whitney U test, and Spearman correlation. In addition, a multiple linear regression was used to analyze whether there were any influential factors on a psychological aspect. Statistical significance was taken at P < 0.05. Results: A total of 271 respondents completed the questionnaire. They tended to have positive perceptions toward the outcomes of orthodontic treatment. There was a significant difference in self-perceived esthetics between the male and female groups. Self-perceived esthetic and functional concerns as well as satisfaction of treatment procedures were found to have significant correlations with the psychological aspect. Sex and self-perceived esthetics were also found to be significant predictors of the psychological aspect. Conclusion: PROMs/PREMs should be considered as an important tool to assess treatment outcomes in orthodontic practice. There appeared to be significant impact of self-perceived esthetics on psychological aspects. Consequently, PROMs and PREMs should be introduced in orthodontic postgraduate programs to enhance the concept of patient-centered care in orthodontic practice.
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Riordain RN, Glick M, Mashhadani SSAA, Aravamudhan K, Barrow J, Cole D, Crall JJ, Gallagher JE, Gibson J, Hegde S, Kaberry R, Kalenderian E, Karki A, Celeste RK, Listl S, Myers SN, Niederman R, Severin T, Smith MW, Murray Thomson W, Tsakos G, Vujicic M, Watt RG, Whittaker S, Williams DM. Developing a Standard Set of Patient-centred Outcomes for Adult Oral Health - An International, Cross-disciplinary Consensus. Int Dent J 2021; 71:40-52. [PMID: 33616051 PMCID: PMC9275363 DOI: 10.1111/idj.12604] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Objective To develop a minimum Adult Oral Health Standard Set (AOHSS) for use in clinical practice, research, advocacy and population health. Materials and methods An international oral health working group (OHWG) was established, of patient advocates, researchers, clinicians and public health experts to develop an AOHSS. PubMed was searched for oral health clinical and patient-reported measures and case-mix variables related to caries and periodontal disease. The selected patient-reported outcome measures focused on general oral health, and oral health-related quality of life tools. A consensus was reached via Delphi with parallel consultation of subject matter content experts. Finally, comments and input were elicited from oral health stakeholders globally, including patients/consumers. Results The literature search yielded 1,453 results. After inclusion/exclusion criteria, 959 abstracts generated potential outcomes and case-mix variables. Delphi rounds resulted in a consensus-based selection of 80 individual items capturing 31 outcome and case-mix concepts. Global reviews generated 347 responses from 87 countries, and the patient/consumer validation survey elicited 129 responses. This AOHSS includes 25 items directed towards patients (including demographics, the impact of their oral health on oral function, a record of pain and oral hygiene practices, and financial implications of care) and items for clinicians to complete, including medical history, a record of caries and periodontal disease activity, and types of dental treatment delivered. Conclusion In conclusion, utilising a robust methodology, a standardised core set of oral health outcome measures for adults, with a particular emphasis on caries and periodontal disease, was developed.
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Affiliation(s)
- Richeal Ni Riordain
- ICHOM Adult Oral Health Working Group, Boston, MA, USA; University College London, London, UK; University College Cork, Cork, Ireland.
| | - Michael Glick
- ICHOM Adult Oral Health Working Group, Boston, MA, USA; FDI Vision 2020 Think Tank, Geneva, Switzerland; School of Dental Medicine, University at Buffalo, Buffalo, NY, USA
| | | | - Krishna Aravamudhan
- ICHOM Adult Oral Health Working Group, Boston, MA, USA; American Dental Association, Chicago, IL, USA
| | - Jane Barrow
- ICHOM Adult Oral Health Working Group, Boston, MA, USA; Harvard School of Dental Medicine, Boston, MA, USA
| | - Deborah Cole
- ICHOM Adult Oral Health Working Group, Boston, MA, USA; Dental Health Services Victoria, Melbourne, Vic., Australia
| | - James J Crall
- ICHOM Adult Oral Health Working Group, Boston, MA, USA; UCLA School of Dentistry, Los Angeles, CA, USA
| | - Jennifer E Gallagher
- ICHOM Adult Oral Health Working Group, Boston, MA, USA; King's College London, London, UK
| | - Jacqui Gibson
- ICHOM Adult Oral Health Working Group, Boston, MA, USA
| | - Shalika Hegde
- Dental Health Services Victoria, Melbourne, Vic., Australia
| | | | - Elsbeth Kalenderian
- ICHOM Adult Oral Health Working Group, Boston, MA, USA; UCSF School of Dentistry, San Francisco, CA, USA
| | - Anup Karki
- ICHOM Adult Oral Health Working Group, Boston, MA, USA; Public Health Wales, Cardiff, UK
| | - Roger Keller Celeste
- ICHOM Adult Oral Health Working Group, Boston, MA, USA; Federal University of Rio Grande do Sol, Porto Alegre, Grande do Sul, Brazil
| | - Stefan Listl
- ICHOM Adult Oral Health Working Group, Boston, MA, USA; FDI Vision 2020 Think Tank, Geneva, Switzerland; Department of Conservative Dentistry, Heidelberg University Clinics, Heidelberg, Germany; Department of Dentistry - Quality and Safety of Oral Health Care, Radboud University - Radboudumc (RIHS), Nijmegen, The Netherlands
| | - Stacie N Myers
- International Consortium for Health Outcomes Measurement (ICHOM), Boston, MA, USA
| | - Richard Niederman
- ICHOM Adult Oral Health Working Group, Boston, MA, USA; NYU College of Dentistry, New York, NY, USA
| | - Tania Severin
- FDI World Dental Federation (FDI), Geneva, Switzerland
| | - Mark W Smith
- ICHOM Adult Oral Health Working Group, Boston, MA, USA; Hospitals Contribution Fund, Sydney, NSW, Australia
| | - W Murray Thomson
- ICHOM Adult Oral Health Working Group, Boston, MA, USA; University of Otago, Dunedin, New Zealand
| | - Georgios Tsakos
- ICHOM Adult Oral Health Working Group, Boston, MA, USA; University College London, London, UK; FDI Vision 2020 Think Tank, Geneva, Switzerland
| | - Marko Vujicic
- ICHOM Adult Oral Health Working Group, Boston, MA, USA; American Dental Association, Chicago, IL, USA
| | - Richard G Watt
- University College London, London, UK; FDI Vision 2020 Think Tank, Geneva, Switzerland
| | - Sarah Whittaker
- International Consortium for Health Outcomes Measurement (ICHOM), Boston, MA, USA
| | - David M Williams
- ICHOM Adult Oral Health Working Group, Boston, MA, USA; FDI Vision 2020 Think Tank, Geneva, Switzerland; Bart's and The London, School of Medicine and Dentistry, Queen Mary, University of London, London, UK
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Tellez M, Meraner M, Lim S, Brandon R, Ismail A. An innovative approach to assess comprehensive care: Temple University's patient wellness report. J Dent Educ 2020; 85:652-659. [PMID: 33368251 DOI: 10.1002/jdd.12521] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 11/12/2002] [Accepted: 12/01/2002] [Indexed: 11/11/2022]
Abstract
PURPOSE The transition from a paper-based to an all-electronic patient health record took a major step forward in 2018, with the implementation of an electronic health record that supports the School's patient-centered comprehensive care model and facilitates outcomes assessment. The Patient Wellness Report (PWR) summarizes findings of the patient assessment, and it does so automatically by locating data already entered in axiUm forms. This study aimed to describe the PWR implementation procedures and to examine outcomes and characteristics among patients with completed treatment plans during an 18-month period. METHODS Outcome data were extracted from axiUm for patients aged ≥16 years who completed comprehensive care treatment plans. Each PWR contained 14 metrics related to "dimensions" of wellness (quality of life, general health factors, oral hygiene, caries risk, and degree of periodontal inflammation and pocketing), each of which is rated on a 3-point scale based on best available scientific evidence. RESULTS A total of 2074 patients completed planned procedures between July 2018 and January 2020, and met the study eligibility criteria. Improvement of several conditions was observed between baseline and follow-up in caries lesions (21%), blood pressure (9%), and periodontal pocket (3.2%). A majority of patients rated in good condition at baseline had their scores unchanged at follow-up in the following areas: dental anxiety (92%), speaking (88%), smoking (87%), and alcohol consumption (79%). CONCLUSION Improvements in dental caries and blood pressure metrics were easily monitored using the PWR. In addition, disparities exist in improvement of patient outcomes by race/ethnicity.
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Affiliation(s)
- Marisol Tellez
- Department of Oral Health Sciences, Maurice H. Kornberg School of Dentistry, Temple University, Philadelphia, Pennsylvania, USA
| | - Mark Meraner
- Department of Restorative Dentistry, Maurice H. Kornberg School of Dentistry, Temple University, Philadelphia, Pennsylvania, USA
| | - Sungwoo Lim
- Maurice H. Kornberg School of Dentistry, Temple University, Philadelphia, Pennsylvania, USA
| | - Ryan Brandon
- Maurice H. Kornberg School of Dentistry, Temple University, Philadelphia, Pennsylvania, USA
| | - Amid Ismail
- Department of Restorative Dentistry, Maurice H. Kornberg School of Dentistry, Temple University, Philadelphia, Pennsylvania, USA
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Ladewig NM, Tedesco TK, Gimenez T, Braga MM, Raggio DP. Patient-reported outcomes associated with different restorative techniques in pediatric dentistry: A systematic review and MTC meta-analysis. PLoS One 2018; 13:e0208437. [PMID: 30521577 PMCID: PMC6283634 DOI: 10.1371/journal.pone.0208437] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 11/17/2018] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Despite the increasing number of studies evaluating patient reported outcome measures (PROs), there is no clearness regarding which restorative treatment offers major benefits based on the pediatric patient perspective. AIM To compare different restorative techniques in pediatric dentistry regarding patient-reported outcomes. DESIGN Literature searching was carried out on prospective studies indexed in PubMed, Scopus and OpenGrey. A Mixed Treatment Comparisons (MTC) meta-analysis was undertaken considering the results from reviewed studies. Anxiety, pain and quality of life were extracted as mean with standard deviation, percentage of pain, and mean difference of scores with standard deviation, respectively. For direct comparisons, data were combined using a random-effect model. Heterogeneity was assessed with the I2 statistic. For indirect comparisons, fixed and random effects were chosen through comparison of competing models based on the Deviance Information Criteria (DIC). The expected efficacy ranking based on the posterior probabilities of all treatment rankings was also calculated. RESULTS An initial search resulted in 4,322 articles, of which 17 were finally selected. Due to unavailability of data, only pain, anxiety and oral health related quality of life (OHRQoL) were statistically analyzed. The difference in means (95% CI) of anxiety between treatments using only hand instruments with or without chemomechanical agents were -5.35 (-6.42 to -4.20) and -5.79 (-7.77 to -3.79) respectively when compared to conventional treatment using rotary instruments and/or local anesthesia. Regarding pain, there was a trend for treatments without rotary instruments and local anesthesia to be less frequently reported as painful. No statistical difference was found intragroup nor among treatments for OHRQoL. CONCLUSIONS Anxiety and pain are directly related with more invasive restorative treatments. On the other hand, quality of life is not improved regardless of the restorative technique used. Further well-designed prospective studies regarding PROs in children are still necessary.
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Affiliation(s)
- Nathalia Miranda Ladewig
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Tamara Kerber Tedesco
- Department of Pediatric Dentistry, Faculty of Dentistry, University of Ibirapuera, São Paulo, São Paulo, Brazil
| | - Thaís Gimenez
- Department of Pediatric Dentistry, Faculty of Dentistry, University of Ibirapuera, São Paulo, São Paulo, Brazil
| | - Mariana Minatel Braga
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Daniela Prócida Raggio
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, University of São Paulo, São Paulo, São Paulo, Brazil
- * E-mail:
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