Patient-Reported Oral Health Outcomes Measurement Information System

描述（由申请人提供）：口腔健康和牙齿状况对一个人的功能和健康至关重要。尽管通过采取安全有效的预防措施在减少牙齿问题和口腔疾病方面取得了重大进展，但牙齿问题和口腔疾病仍然非常普遍，严重影响了与健康有关的生活质量。在生命的早期阶段，儿童和青少年特别容易受到伤害;他们要么有乳牙， 乳牙和恒牙的混合或刚刚获得恒牙，但暴露于高糖和碳水化合物的饮料和食物，这是牙齿问题的主要原因，在他们的一生中产生长期影响。虽然基于临床的健康结果是客观的，并经常被用作黄金标准，但患者报告的结果（PRO）是对健康的第一手感受和看法，反映了对患者最重要的是什么。自我报告是有效的，比临床检查或实验室测试更具成本效益。开发患者报告结局测量信息系统（PROMIS（R））是为了创建项目库，提供有效，灵活和精确的测量潜力。尽管存在许多口腔健康调查，但它们因缺乏系统性、准确性、有效性、标准化和跨研究和疾病的可比性而受到限制。到目前为止，没有现有的口腔健康项目库，也没有相关的短期和长期的形式来衡量口腔健康。我们建议使用科学PROMIS定性和定量方法来开发第一个口腔健康项目库，可供口腔健康专业人员，研究人员和政策制定者使用，以有效地测量2-17岁儿童和青少年（分为2- 7，8-13和14-17岁）的口腔健康结果。具体而言，我们将（1）利用现有的PROMIS方法开发口腔健康项目库和有效的短、长量表，以填补PROMIS项目库系统中的差距;（2）校准和评估口腔健康项目库的可接受性、信度和结构效度，并对从15个不同牙科站点随机选择的600名儿童和青少年进行短、长量表的评估;以及（3）将口腔健康库中的项目与临床确定的和传统的口腔健康和一般健康测量相关联，并且估计最小重要差异和对随时间变化的响应性。通过严格的研究设计和分析方法，这些目标将通过四个明确定义的操作阶段来实现：（I）文献综述和PROMIS与口腔健康的相关性评估;（II）焦点小组，认知访谈和最终项目选择;（III）调查和临床检查的现场测试;和（IV）评估，包括统计和心理测量分析，口腔健康项目。从这个项目开发的口腔健康项目库和短期和长期的形式，可用于许可机构，医疗补助计划，社区诊所和私人诊所，口腔健康研究人员和专业人员的口腔健康筛查，护理质量评估，口腔健康计划评估和政策规划。1

DESCRIPTION (provided by applicant): Oral health and dental conditions are critical to a person's functioning and well-being. Despite significant progress in reducing dental problems and oral diseases through adoption of safe and effective preventions, dental problems and oral diseases are still very prevalent, significantly affecting health-related quality of life. In the erly life cycle, children and adolescents are particularly vulnerable; they have either primary teeth, a mix of primary and permanent teeth or have just gotten permanent dentition, but are exposed to drinks and foods that are high in sugar and carbohydrates which are the primary causes of dental problems with long-term impacts throughout their life course. Although clinically-based health outcomes are objective and often used as gold standards, patient-reported outcomes (PROs) are first-hand feeling and perceptions about health that reflect what is most important to patients. Self-reports are efficient and are more cost-effective than clinical examinations or laboratory tests. The Patient-Reported Outcomes Measurement Information System (PROMIS(R)) was developed to create item banks that offer the potential for efficient, flexible and precise measurement. Despite the fact that many oral health surveys exist, they are limited by lack of systematization, precision, effectiveness, standardization and comparability across studies and diseases. To date, there are no existing oral health item banks available, nor are there associated short and long forms for measuring oral health. We propose to use state-of-the-science PROMIS qualitative and quantitative approaches to develop the first oral health item banks that can be used by oral health professionals, researchers and policy makers to effectively measure oral health outcomes among children and adolescents, ages 2-17 years (grouped as 2- 7, 8-13 and 14-17 years.) Specifically, we will (1) use existing PROMIS methodologies to develop oral health item banks and effective short and long forms to fill the gap in the PROMIS item bank systems; (2) calibrate and evaluate the acceptability, reliability and construct validity of the oral health item pool, and assess the short and long forms with randomly selected 600 children and adolescents from 15 diverse dental sites; and (3) link items in oral health banks with clinically determined and legacy oral health and general health measures, and estimate minimally important differences and responsiveness to change over time. With rigorous study design and analytical methods, these aims will be accomplished through four clearly defined operational phases: (I) literature review and evaluation of the relevance of PROMIS to oral health; (II) focus groups, cognitive interviews, and final item selection; (III) field testing of survey and clinical examination; and (IV) evaluation, including statistical and psychometric analyses, of the oral health items. The oral health items banks and short and long forms developed from this project can be used by licensing agencies, Medicaid programs, community clinics and private practices, and oral health researchers and professionals for oral health screening, quality of care assessment, oral health program evaluation and policy planning. 1