Geisler Benjamin P, Ji Yisi D, Peacock Zachary S
Instructor, Department of Medicine, Massachusetts General Hospital, Boston, MA.
DMD Candidate, Harvard School of Dental Medicine, Boston, MA.
J Oral Maxillofac Surg. 2017 Nov;75(11):2287-2303. doi: 10.1016/j.joms.2017.05.007. Epub 2017 May 18.
The purpose of this study is to describe the state of economic analyses in the field of oral and maxillofacial surgery (OMS).
A systematic search of published literature up to 2016 was performed. The inclusion criteria were as follows: English-language articles on economic analyses pertaining to OMS including anesthesia and pain management; dentoalveolar surgery; orthognathic, cleft, and/or obstructive sleep apnea treatment; pathology; reconstruction; temporomandibular disorders; trauma; and other. The exclusion criteria were as follows: opinion or perspective articles, studies unrelated to OMS, nonhuman research, and implant-related studies. Cost-effectiveness analyses (CEAs), cost-utility analyses, and cost-minimization analyses (CMAs) were evaluated with the original Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist or a modified CHEERS checklist.
The search yielded 798 articles, 77 of which met the inclusion criteria (published from 1980 to 2016, 48 from the United States). There were an increasing number of studies over time (P for trend < .01). There were 7 economic studies on anesthesia and pain management (9.1%); 16 studies on dentoalveolar surgery (20.7%); 15 studies on orthognathic, cleft, and/or obstructive sleep apnea treatment (19.4%); 1 study on pathology (1.3%); 6 studies on reconstruction (7.8%); no studies on temporomandibular joint disorders and/or facial pain (0%); 20 studies on trauma (25.9%); and 12 studies categorized as other (15.5%). CEAs made up 11.7% of studies, and CMAs comprised 58.4%. Of the 9 CEAs, 55.6% were published in 2010 or later. Of the 45 CMAs, 88.6% were published in 2000 or later and 61.4% in 2010 or later. CEAs met 56.0% (range, 29.2 to 87.5%) of the CHEERS criteria, whereas CMA studies met 45.1% (range, 23.9 to 76.1%) of the modified CHEERS criteria. Only 1 study succeeded in estimating costs and health outcomes (value) of an OMS procedure.
There is an increasing trend in the number of economic studies in the field of OMS. More high-quality economic evaluations are needed to demonstrate the value of OMS procedures. To determine value, future studies should compare both costs and health-related outcomes.
本研究旨在描述口腔颌面外科（OMS）领域的经济分析状况。
对截至2016年已发表的文献进行系统检索。纳入标准如下：关于OMS经济分析的英文文章，包括麻醉和疼痛管理；牙槽外科；正颌、腭裂和/或阻塞性睡眠呼吸暂停治疗；病理学；重建；颞下颌关节紊乱病；创伤；以及其他。排除标准如下：观点或评论文章、与OMS无关的研究、非人体研究以及与种植相关的研究。采用原始的《综合卫生经济评估报告标准》（CHEERS）清单或修改后的CHEERS清单对成本效益分析（CEA）、成本效用分析以及成本最小化分析（CMA）进行评估。
检索共得到798篇文章，其中77篇符合纳入标准（发表于1980年至2016年，48篇来自美国）。随着时间推移，研究数量呈增加趋势（趋势P <.01）。关于麻醉和疼痛管理的经济研究有7项（9.1%）；牙槽外科研究16项（20.7%）；正颌、腭裂和/或阻塞性睡眠呼吸暂停治疗研究15项（19.4%）；病理学研究1项（1.3%）；重建研究6项（7.8%）；颞下颌关节紊乱病和/或面部疼痛研究无（0%）；创伤研究20项（25.9%）；其他分类研究12项（15.5%）。CEA占研究的11.7%，CMA占58.4%。在9项CEA中，55.6%发表于2010年或之后。在45项CMA中，88.6%发表于2000年或之后，61.4%发表于2010年或之后。CEA符合CHEERS标准的56.0%（范围为29.2%至87.5%），而CMA研究符合修改后CHEERS标准的45.1%（范围为23.9%至76.1%）。仅有1项研究成功估算了OMS手术的成本和健康结局（价值）。
OMS领域的经济研究数量呈增加趋势。需要更多高质量的经济评估来证明OMS手术的价值。为确定价值，未来研究应同时比较成本和与健康相关的结局。
