Economic Evaluation of the Protecting Teeth @ 3 Randomized Controlled Trial.
Economic Evaluation of the Protecting Teeth @ 3 Randomized Controlled Trial.
复制标题
DOI：
10.1177/23800844221090444
复制
发表时间：
2023-07
影响因子：
--
通讯作者：
McIntosh, E.
中科院分区：
文献类型：
--
作者：
Anopa, Y.;Macpherson, L. M. D.;McMahon, A. D.;Wright, W.;Conway, D., I;McIntosh, E.
关键词：
经济评估 (EE) 与随机对照试验（保护牙齿 @ 3 研究 [PT@3]）同时进行，探索与在同一托儿所照常治疗 (TAU) 相比，在幼儿园每 6 个月使用氟化物清漆 (FV) 的额外预防价值。除了托儿所 FV 之外，TAU 还代表了一项多组成部分的国家儿童口腔健康改善干预措施——Childsmile 计划。 EE 是比较 FV 和 TAU 组的试验内成本效用分析 (CUA)。 CUA 是从国家卫生服务的角度进行的，并遵循相关方法指导。试验内成本包括干预成本和医疗保健资源使用成本。健康结果以 2 年随访期间累积的质量调整生命年 (QALY) 表示。使用儿童健康效用 9 维度调查问卷来获得效用分数。采用国家参考成本，公共卫生干预措施采用1.5%的贴现率，采用缺失数据的多重插补方法，进行敏感性分析，计算增量成本效用比。 EE 分析中使用了 2014-2015 年 PT@3 摄入量的 534 名参与者的数据，其中 FV 组 n = 265 (50%)，TAU 组 n = 269 (50%)。 FV 组中每个孩子的平均增量成本为 68.37 英镑（P = 0.382；95% 置信区间 [CI]，–18.04 英镑至 143.82 英镑）。平均增量 QALY 为 -0.004（P = 0.636；95% CI，-0.016 至 0.007）。在英国 20,000 英镑门槛下，FV 干预具有成本效益的概率为 11.3%。结果表明，考虑到英国当前的门槛，除了 TAU（Childsmile 的所有其他组成部分，除了托儿所 FV 之外）之外，在托儿所应用 FV 不会被认为具有成本效益。鉴于先前已证明 Childsmile 通用幼儿刷牙组件的临床有效性和经济价值，应审查在 COVID-19 之前的形式中继续使用额外的、有针对性的幼儿 FV 组件，因为其成本效益的可能性较低。这项研究的结果可供儿童口腔健康政策制定者和牙科公共卫生专业人员使用。它们可以构成证据的一部分，为苏格兰、英国和国际有关基于社区的儿童口腔健康促进计划的指导提供信息。
An economic evaluation (EE) was conducted alongside a randomized controlled trial (the Protecting Teeth @ 3 Study [PT@3]), exploring the additional preventive value of fluoride varnish (FV) application at 6-monthly intervals in nursery schools compared to treatment as usual (TAU) in the same nurseries. TAU represented a multicomponent national child oral health improvement intervention, the Childsmile program, apart from nursery FV. The EE was a within-trial cost-utility analysis (CUA) comparing the FV and TAU groups. The CUA was conducted from a National Health Service perspective and followed relevant methods guidance. Within-trial costs included intervention costs and health care resource use costs. Health outcomes were expressed in quality-adjusted life years (QALYs) accrued over the 2-y follow-up period. The Child Health Utility 9 Dimensions questionnaire was used to obtain utility scores. National reference costs were used, a discount rate of 1.5% for public health interventions was adopted, multiple imputation methods for missing data were employed, sensitivity analyses were conducted, and incremental cost-utility ratios were calculated. Data from 534 participants from the 2014–2015 PT@3 intake were used in the EE analyses, n = 265 (50%) in the FV arm and n = 269 (50%) in the TAU arm. Mean incremental cost per child in the FV arm was £68.37 (P = 0.382; 95% confidence interval [CI], –£18.04 to £143.82). Mean incremental QALY was −0.004 (P = 0.636; 95% CI, −0.016 to 0.007). The probability that the FV intervention was cost-effective at the UK £20,000 threshold was 11.3%. The results indicate that applying FV in nurseries in addition to TAU (all other components of Childsmile, apart from nursery FV) would not be deemed cost-effective given current UK thresholds. In view of previously proven clinical effectiveness and economic worthiness of the universal nursery toothbrushing component of Childsmile, continuation of the additional, targeted nursery FV component in its pre–COVID-19 form should be reviewed given its low probability of cost-effectiveness. The results of this study can be used by child oral health policy makers and dental public health professionals. They can form part of the evidence to inform the Scottish, UK, and international guidance on community-based child oral health promotion programs.
登录
查看更多内容
影响因子：
4.2
作者：
McMahon, Alex D.;Wright, William;Macpherson, Lorna M. D.
通讯作者：
Macpherson, Lorna M. D.
影响因子：
7.6
作者：
Macpherson, L. M. D.;Anopa, Y.;McMahon, A. D.
通讯作者：
McMahon, A. D.
影响因子：
0.9
作者：
Steele, Michael M.;Steele, Ric G.;Varni, James W.
通讯作者：
Varni, James W.
影响因子：
2.9
作者：
Kidd JB;McMahon AD;Sherriff A;Gnich W;Mahmoud A;Macpherson LM;Conway DI
通讯作者：
Conway DI
影响因子：
2.4
作者：
Barber, Julie;Thompson, Simon
通讯作者：
Thompson, Simon