A multi-centered epidemiological study evaluating the validity of the treatment difficulty indices developed by the Japan Prosthodontic Society
A multi-centered epidemiological study evaluating the validity of the treatment difficulty indices developed by the Japan Prosthodontic Society
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DOI：
10.1016/j.jpor.2017.08.002
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发表时间：
2018-04-01
影响因子：
3.6
通讯作者：
Matsumura, Hideo
中科院分区：
文献类型：
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作者：
Kuboki, Takuo;Ichikawa, Tetsuo;Matsumura, Hideo
目的：日本口腔修复学会开发了一种多轴评估方案，以评估需要口腔修复护理的患者的复杂变化，并对治疗难度进行分级。之前的一份报告发现该协议足够可靠。这项多中心队列研究的目的是评估该多轴评估方案的有效性。方法：在开始修复治疗之前使用多轴评估方案评估治疗难度。治疗完成后评估积极修复治疗所需的时间、治疗费用等医疗资源以及治疗前后口腔健康相关生活质量的变化。该协议的结构有效性通过牙医术前对治疗难度的主观评估与该协议确定的难度水平之间的相关性进行评估。评估预测有效性，评估基于该方案四个轴的“治疗难度综合水平”与总治疗成本、总治疗时间以及治疗前后口腔健康相关生活质量的变化之间的相关性。结果：除心理评估外，该方案的结构有效性得到了充分记录。关于预测有效性，治疗前评估的治疗难度综合水平与已知与治疗难度相关的三个替代终点（总治疗费用、治疗时间和口腔健康相关生活质量的改善）显着相关。为了根据患者的口腔状况进一步阐明该方案的有效性，进行了按缺陷进行的亚组分析。分析显示，全口无牙颌患者和部分无牙颌患者的治疗前治疗难度评估与一或两个替代终点显着相关。在全/部分无牙颌混合患者和有牙齿问题的患者中没有观察到显着关系，可能是由于这些组中的样本量较小。结论：本研究表明，多轴评估方案足以有效地预测全无牙颌缺损和部分无牙颌缺损患者的修复护理治疗难度水平。 (c) 2017 年日本口腔修复学会。由爱思唯尔有限公司出版。保留所有权利。
Purpose: The Japan Prosthodontic Society developed a multi-axis assessment protocol to evaluate the complex variations in patients who need prosthodontic care, and to classify the level of treatment difficulty. A previous report found the protocol to be sufficiently reliable. The purpose of this multi-center cohort study was to evaluate the validity of this multi-axis assessment protocol.Methods: The treatment difficulty was evaluated using the multi-axis assessment protocol before starting prosthodontic treatment. The time required for active prosthodontic treatment, medical resources such as treatment cost, and changes in the oral health-related QOL before and after treatment, were evaluated after treatment completion. The construct validity of this protocol was assessed by the correlation between the dentist's pre-operative subjective assessment of the treatment difficulty, and the level of difficulty determined by this protocol. The predictive validity was assessed estimating the correlations between a "comprehensive level of treatment difficulty" based on the four axes of this protocol and total treatment cost, total treatment time, and changes in the oral health-related QOL before and after treatment.Results: The construct validity of this protocol was well documented except for psychological assessment. Regarding the predictive validity, the comprehensive level of treatment difficulty assessed before treatment was significantly correlated with the three surrogate endpoints known to be related to the treatment difficulty (total treatment cost, treatment time, and improvement in the oral health-related QOL). To further clarify the validity of the protocol according to patients' oral condition, a subgroup analysis by defects was performed. Analyses revealed that treatment difficulty assessment before treatment was significantly related to one or two surrogate endpoints in the fully edentulous patients and the partially edentulous patients. No significant relationship was observed in the patients with mixture of full/partial edentulism and the patients with teeth problems, possibly due to the small sample size in these groups.Conclusion: This study revealed that the multi-axis assessment protocol was sufficiently valid to predict the level of treatment difficulty in prosthodontic care in patients with fully edentulous defects and with partially edentulous defects. (c) 2017 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.