Tulloch J F, Antczak-Bouckoms A A
Department of Orthodontics, School of Dentistry, University of North Carolina, Chapel Hill 27514.
J Dent Educ. 1987 Nov;51(11):652-60.
Quantitative methods of technology assessment that consider the magnitude of the technology's effect and also incorporate the elements of uncertainty, risk, and preference are needed. This study uses the methods of decision analysis to evaluate a common dental problem: whether or not to extract asymptomatic mandibular third molars. Three alternative strategies are considered. The expected disability of an extraction, measured as equivalent "days of standard discomfort" (DSD), is used as the outcome measure of interest. The analysis suggests that under a wide range of assumptions about the likelihood of different impaction types, chance of pathology, probability of extraction complications, and disability associated with each complication, the strategy of extracting only pathologically involved impacted mandibular third molars is generally the risk-minimizing option. The sensitivity analysis identifies the severity of the outcome in the presence of pathology as a possible risk factor that requires further investigation.
需要采用定量技术评估方法，这些方法既要考虑技术效果的大小，又要纳入不确定性、风险和偏好等因素。本研究使用决策分析方法来评估一个常见的牙科问题：是否拔除无症状的下颌第三磨牙。考虑了三种替代策略。拔牙的预期残疾程度以等效的“标准不适天数”（DSD）来衡量，用作感兴趣的结果指标。分析表明，在关于不同阻生类型的可能性、病理发生几率、拔牙并发症概率以及每种并发症相关残疾程度的广泛假设下，仅拔除病理累及的阻生下颌第三磨牙的策略通常是风险最小化的选择。敏感性分析确定了病理情况下结果的严重程度是一个可能需要进一步研究的风险因素。
