Assessment of outcomes and cost-effectiveness in early orthodontic treatment

早期正畸治疗的结果和成本效益评估

• 批准号: 8617583
• 负责人: James J Chen
• 金额: $ 13.31万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-01 至 2015-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8617583
• 关键词: Adult; Aftercare; Award; Biostatistical Methods; Caring; Child; Childhood; Clinic; Clinical; Clinical Research; Clinical Trials; Communities; Cost Effectiveness Analysis; Cross Bite; Data; Decision Trees; Dental; Dental Care; Dental Insurance; Dentistry; Development; Diabetes Mellitus; Disadvantaged; Educational process of instructing; Enrollment; Evaluation; Family; Goals; Gold; Government; Health; Healthcare; Immigrant; Improve Access; Individual; Interceptive Orthodontics; Intervention Trial; K-Series Research Career Programs; Knowledge; Learning; Life; Linear Regressions; Literature; Low income; Malocclusion; Measures; Medical; Medicine; Mentored Patient-Oriented Research Career Development Award; Mentors; Minority; Mixed Dentition; Modeling; Oral health; Orthodontic; Orthodontics; Outcome; Outcome Assessment; Participant; Patients; Perception; Periodontitis; Population; Preventive; Protocols documentation; Provider; Public Health; Quality of life; Questionnaires; Recruitment Activity; Regression Analysis; Research; Research Design; Research Personnel; Research Project Grants; Research Support; Residencies; Rural; Rural Community; School Dentistry; Science; Self Perception; Staging; Tooth structure; Training; Treatment Cost; Treatment Protocols; Treatment outcome; United States; Universities; Washington; Work; base; career; clinical epidemiology; cost; cost effective; cost effectiveness; dental casting; design; evidence base; experience; health care economics; health disparity; indexing; novel; peer; permanent tooth; professor; public health relevance; research study; socioeconomics; standard care; tooth crowding; trial comparing

Abstract This is an application for a K23 Mentored Research Career Development Award for Dr. James Chen, an Assistant Professor and Orthodontist at UCSF. Dr. Chen is working to establish his research on early interceptive orthodontic treatment for socially disadvantaged children and his clinical expertise. This application is designed to provide the necessary mentoring, training, and research support Dr. Chen needs to become a successful independent investigator. Specifically, this award sets out to accomplish the following goals: (1) become an expert in patient-based early interceptive orthodontic treatment research; (2) to determine the equivalence in treatment outcome and child self-perception between a removable-appliance-based protocol and a fixed-appliance-based protocol; (3) to learn and implement advanced biostatistical methods in clinical research; (4) to learn and implement cost-effectiveness analysis models on early interceptive orthodontic treatment protocols; (5) to develop and grow a strong independent clinical research career; (6) to be a leader in access to orthodontic health care in the United States. In order for Dr. Chen to achieve these goals he will need support to design and implement his study. Dr. Chen has assembled a diverse mentoring team comprised of a primary mentor, Dr. George Taylor, who is the Department Chair of Preventive and Restorative Sciences and conducts public-health-related research on diabetes and periodontitis, and three co-mentors with one consultant: Dr. Greg Huang, Chair of Orthodontics at the University of Washington, who is an expert on evidenced based orthodontic research; Dr. James Kahn, Professor of Clinical Epidemiology in Medicine at UCSF, who is an expert on cost-effectiveness analysis and health care economics; Dr. Jing Cheng, Associate Professor in the School of Dentistry, who is an expert on study design and biostatistical analysis; and Dr. Gerald Nelson, Acting Chair of Division of Orthodontics at UCSF, will serve as a clinical consultant because of his extensive knowledge and experience with early interceptive orthodontic treatment. Oral health disparities and access to orthodontic care for socially disadvantaged children is a major concern in the United States. Dr. Chen's research will focus on critically analyzing a novel removable appliance based treatment protocol aimed at reducing orthodontic need while limiting the financial impact on low-income families compared to the existing fixed appliance based treatment protocol. The hypothesis of this study is that a treatment protocol based on using removable appliances provides the same treatment outcome but better cost-effectiveness than a traditional fixed-appliance protocol. The crux of this study will include comparing the differences in treatment outcome (AIM 1), measured by occlusal index scores (PAR Index and ICON Index), the differences in child self-perception measured by Child Perception Questionnaire (AIM 2) after orthodontic treatment, and the difference in cost-effectiveness (AIM 3) between the removable appliance only group and the fixed appliances only group. For all three aims, Dr. Chen will recruit participants beginning early interceptive orthodontic treatment at La Clinica Community Clinic and UCSF Orthodontic Residency Clinic and he will follow them to completion of their orthodontic treatment and then progression into full permanent dentition. This study will require sophisticated multiple linear regression analyses. This research will be the starting point for developing and initiating a large intervention trial comparing removable based appliance therapy to fixed appliance based therapy for socially disadvantaged children. Towards the end of this K23 award Dr. Chen will prepare and apply for a R34 award to develop the intervention trial followed by an application for an U01 clinical trial award.

摘要 这是为詹姆斯·陈博士申请K23导师研究职业发展奖，他是一名 加州大学旧金山分校助理教授兼正畸医生。陈博士正在努力建立他的早期研究 社会弱势儿童的阻断性正畸治疗及其临床专业知识。此应用程序 旨在提供必要的指导、培训和研究支持，陈博士需要成为 成功的独立调查员。具体地说，该奖项旨在实现以下目标：(1) 成为以患者为基础的早期拦截正畸治疗研究的专家；(2)确定 基于可拆卸矫治器的治疗方案在治疗结果和儿童自我知觉方面的等价性 和基于固定矫治器的方案；(3)学习和应用先进的生物统计学方法在临床上 研究；(4)学习和实施早期拦截正畸的成本-效果分析模型 治疗方案；(5)发展和壮大强大的独立临床研究事业；(6)在 在美国获得正畸保健的机会。为了让陈博士实现这些目标，他将 需要支持来设计和实施他的研究。陈博士组建了一支多元化的指导团队 由一位主要导师乔治·泰勒博士组成，他是预防和恢复系主任 从事糖尿病和牙周炎的公共健康相关研究，并与 一位顾问：格雷格·黄博士，华盛顿大学正畸教授，他是一位 循证正畸研究；詹姆斯·卡恩博士，医学临床流行病学教授 加州大学旧金山分校，成本效益分析和医疗保健经济学专家；郑静博士，助理 牙科学院教授，研究设计和生物统计分析方面的专家； 加州大学旧金山分校正畸科代理主席杰拉尔德·纳尔逊将担任临床顾问，原因是 他在早期拦截正畸治疗方面的丰富知识和经验。 口腔健康差距和社会弱势儿童获得正畸护理的机会是#年的一个主要问题。 美国。陈博士的研究将集中在批判性地分析一种新型的可拆卸矫治器 旨在减少正畸需求的治疗方案，同时限制对低收入者的经济影响 与现有固定矫治器为主的治疗方案进行比较。这项研究的假设是 基于使用可拆卸矫治器的治疗方案提供相同的治疗结果，但效果更好 比传统固定设备协议更具成本效益。这项研究的关键将包括比较 治疗结果差异(AIM 1)，以咬合指数评分(PAR指数和ICON指数)衡量， 儿童知觉问卷(AIM-2)测量正畸后儿童自我知觉的差异 治疗，以及仅可拆卸矫治器组和对照组之间的成本-效果差异(AIM 3 仅限固定电器组。对于所有这三个目标，陈博士将从早期开始招募参与者 La Clinica社区诊所和加州大学旧金山分校正畸住院诊所的截止性正畸治疗 他将跟随他们，直到完成他们的正畸治疗，然后进展到完全永久 牙列。这项研究需要复杂的多元线性回归分析。这项研究将是 开发和启动比较可拆卸矫治器的大型干预试验的起点 从固定矫治器到社会弱势儿童的固定矫治器。在K23接近尾声时 奖项陈医生将准备并申请R34奖金，以开发干预试验，随后 申请U01临床试验奖。