St George's University Hospital's NHS Foundation Trust and Hodsoll House Specialist Practice, Kent, UK.
Barts Health NHS Trust, Whitechapel, London, UK.
Br Dent J. 2018 Aug 24;225(4):325-334. doi: 10.1038/sj.bdj.2018.644.
To explore the feasibility of measuring quality of endodontic care provided by general dental practitioners (GDPs), using clinical, radiographic and patient-related outcomes, as well as understanding practitioner views and estimating financial costs.
Multi-faceted mixed-methods two-part study involving retrospective analysis of the educational component (course assessments, endodontic training blocks and analysis of a sample of teeth treated at the beginning and end of training), and prospective analysis of patients treated by these dentists after completion of training.
Dentists working in and patients treated in primary dental care in London.
Twenty-four-month training in endodontics.
Dentists enrolled in the training at different time points.
Measuring outcome of endodontic treatment.
Eight dentists (mean 36 years, SD = 8.2 years) participated in training. Subsequently, five of these dentists (mean 34.2 years, SD = 7.08 years) contributed to the prospective study and recruited 135 patients. Thirty-five patients completed all patient-related outcome questionnaires, and of these there were 16 cases with complete clinical and radiographic data (12%) at follow-up (10.1–36.4 months). Preliminary analysis revealed that a minimum of 45 cases of complete data would be required for multivariate analysis, requiring the recruitment of in excess of 375 patients to future studies to account for this level of loss to follow-up.
Findings suggest it is possible to carry out mixed-methods and treatment-related outcome-based research in primary care. Measurement/data capture tools developed were tested and used successfully in measuring the adherence to treatment processes and outcome of endodontic treatment.
探索使用临床、影像学和患者相关结果,以及了解从业者观点和估计财务成本,来衡量普通牙科医生(GDPs)提供的牙髓治疗质量的可行性。
多方面的混合方法两部分研究,包括教育部分的回顾性分析(课程评估、牙髓培训块以及培训开始和结束时治疗牙齿的样本分析),以及这些牙医培训完成后治疗的患者的前瞻性分析。
在伦敦初级牙科护理中工作的牙医和接受治疗的患者。
为期 24 个月的牙髓学培训。
在不同时间点参加培训的牙医。
测量牙髓治疗的结果。
8 名牙医(平均 36 岁,标准差=8.2 岁)参加了培训。随后,其中 5 名牙医(平均 34.2 岁,标准差=7.08 岁)参与了前瞻性研究,并招募了 135 名患者。35 名患者完成了所有患者相关的结果问卷,其中有 16 例在随访时(10.1-36.4 个月)有完整的临床和影像学数据(12%)。初步分析表明,需要至少 45 例完整数据进行多变量分析,需要招募超过 375 例患者参加未来的研究,以考虑到这种程度的随访损失。
研究结果表明,在初级保健中进行混合方法和基于治疗结果的研究是可行的。开发的测量/数据采集工具经过测试并成功用于测量牙髓治疗过程的依从性和结果。