Sollenius Ola, Petrén Sofia, Björnsson Liselotte, Norlund Anders, Bondemark Lars
*Department of Orthodontics, County Council, Halland, Halmstad,
**Department of Orthodontics, Faculty of Odontology, Malmö University.
Eur J Orthod. 2016 Jun;38(3):259-65. doi: 10.1093/ejo/cjv040. Epub 2015 Jun 11.
Economic evaluation is assuming increasing importance as an integral component of health services research.
To conduct a systematic review of the literature and assess the evidence from studies presenting orthodontic treatment outcomes and the related costs.
MATERIALS/METHODS: The literature review was conducted in four steps, according to Goodman's model, in order to identify all studies evaluating economic aspects of orthodontic interventions. The search covered the databases Medline, Cinahl, Cochrane, Embase, Google Scholar, National Health Service Economic Evaluation Database, and SCOPUS, for the period from 1966 to September 2014. The inclusion criteria were as follows: randomized controlled trials or controlled clinical trials comparing at least two different orthodontic interventions, evaluation of both economic and orthodontic outcomes, and study populations of all ages. The quality of each included study was assessed as limited, moderate, or high. The overall evidence was assessed according to the GRADE system (The Grading of Recommendations Assessment, Development and Evaluation).
The applied terms for searches yielded 1838 studies, of which 989 were excluded as duplicates. Application of the inclusion and exclusion criteria identified 26 eligible studies for which the full-text versions were retrieved and scrutinized. At the final analysis, eight studies remained. Three studies were based on cost-effectiveness analyses and the other five on cost-minimization analysis. Two of the cost-minimization studies included a societal perspective, i.e. the sum of direct and indirect costs. The aims of most of the studies varied widely and of studies comparing equivalent treatment methods, few were of sufficiently high study quality. Thus, the literature to date provides an inadequate evidence base for economic aspects of orthodontic treatment.
This systematic review disclosed that few orthodontic studies have presented both economic and clinical outcomes. There is currently insufficient evidence available about the health economics of orthodontic interventions. Further investigation is warranted.
经济评估作为卫生服务研究的一个组成部分，其重要性日益增加。
对文献进行系统综述，并评估有关正畸治疗结果及相关成本研究的证据。
材料/方法：根据古德曼模型分四个步骤进行文献综述，以识别所有评估正畸干预经济方面的研究。检索涵盖1966年至2014年9月期间的Medline、Cinahl、Cochrane、Embase、谷歌学术、国家卫生服务经济评估数据库和SCOPUS等数据库。纳入标准如下：比较至少两种不同正畸干预措施的随机对照试验或对照临床试验、经济和正畸结果的评估以及所有年龄段的研究人群。每项纳入研究的质量被评估为有限、中等或高。根据GRADE系统（推荐评估、制定和评价分级）评估总体证据。
搜索所用术语产生了1838项研究，其中989项因重复而被排除。应用纳入和排除标准确定了26项符合条件的研究，检索并仔细审查了其全文版本。最终分析时，剩下8项研究。3项研究基于成本效益分析，另外5项基于成本最小化分析。两项成本最小化研究纳入了社会视角，即直接和间接成本之和。大多数研究的目的差异很大，在比较等效治疗方法的研究中，很少有研究质量足够高。因此，迄今为止的文献为正畸治疗的经济方面提供的证据基础不足。
这项系统综述表明，很少有正畸研究同时呈现经济和临床结果。目前关于正畸干预的卫生经济学证据不足。有必要进行进一步调查。
