Duane B G, Humphris G, Richards D, Okeefe E J, Gordon K, Freeman R
Community Dent Health. 2014 Dec;31(4):200-6.
To assess the use of the WCMT in two Scottish health boards and to consider the impact of simplifying the tool to improve efficient use.
A retrospective analysis of routine WCMT data (47,276 cases).
Public Dental Service (PDS) within NHS Lothian and Highland.
The WCMT consists of six criteria. Each criterion is measured independently on a four-point scale to assess patient complexity and the dental care for the disabled/impaired patient. Psychometric analyses on the data-set were conducted. Conventional internal consistency coefficients were calculated. Latent variable modelling was performed to assess the 'fit' of the raw data to a pre-specified measurement model. A Confirmatory Factor Analysis (CFA) was used to test three potential changes to the existing WCMT that included, the removal of the oral risk factor question, the removal of original weightings for scoring the Tool, and collapsing the 4-point rating scale to three categories.
The removal of the oral risk factor question had little impact on the reliability of the proposed simplified CMT to discriminate between levels of patient complexity. The removal of weighting and collapsing each item's rating scale to three categories had limited impact on reliability of the revised tool. The CFA analysis provided strong evidence that a new, proposed simplified Case Mix Tool (sCMT) would operate closely to the pre-specified measurement model (the WMCT).
A modified sCMT can demonstrate, without reducing reliability, a useful measure of the complexity of patient care. The proposed sCMT may be implemented within primary care dentistry to record patient complexity as part of an oral health assessment.
评估世界口腔保健措施（WCMT）在苏格兰两个卫生委员会中的使用情况，并考虑简化该工具以提高使用效率的影响。
对常规WCMT数据（47276例）进行回顾性分析。
NHS Lothian和Highland内的公共牙科服务（PDS）。
WCMT由六个标准组成。每个标准独立地按四点量表进行测量，以评估患者的复杂程度以及为残疾/受损患者提供的牙科护理。对数据集进行了心理测量分析。计算了传统的内部一致性系数。进行了潜在变量建模，以评估原始数据与预先指定的测量模型的“拟合度”。使用验证性因素分析（CFA）来测试对现有WCMT的三个潜在更改，包括删除口腔危险因素问题、删除该工具评分的原始权重，以及将四点量表简化为三个类别。
删除口腔危险因素问题对拟议简化的CMT区分患者复杂程度水平的可靠性影响很小。删除权重并将每个项目的量表简化为三个类别对修订工具的可靠性影响有限。CFA分析提供了有力证据，表明新的拟议简化病例组合工具（sCMT）的运行将与预先指定的测量模型（WMCT）非常接近。
经过修改的sCMT在不降低可靠性的情况下，可以有效衡量患者护理的复杂程度。拟议的sCMT可在初级牙科保健中实施，以记录患者复杂程度，作为口腔健康评估的一部分。
