Removable Partial Prosthodontics, Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
J Oral Rehabil. 2021 Apr;48(4):449-457. doi: 10.1111/joor.13128. Epub 2020 Dec 3.
The ability of an instrument to detect a clinically important change in patient-reported outcomes following prosthetic treatment is critical for its use in clinical practice and research settings.
This study aimed to examine the responsiveness of instruments in evaluating patient perception of chewing ability after removable partial denture (RPD) treatment in a prospective cohort.
A single 100-mm visual analogue scale (VAS), 20-item food intake questionnaire (FIQ) and 6-point chewing difficulty scale (CDS) were administered to 248 partially edentulous patients to evaluate chewing ability pre- and post-RPD treatment. We conducted a statistical comparison between the pre- and post-treatment scores and determined the effect size (r) of RPD treatment for the instruments.
A significant improvement in chewing ability after RPD treatment was identified by VAS and CDS (P < .05), but not by FIQ (P = .16), which identified an improvement after controlling for sex, age, the number of missing teeth and presence/absence of existing removable dentures. The effect size was medium for VAS (r = .54), weak for CDS (r = .14-.17) and absent for FIQ (r = -.09). The increase in r was significantly associated with impaired chewing ability before treatment (ρ = -0.87, P < .001).
These results suggest that the 100-mm VAS, followed by CDS, is the most responsive instrument to detect an improvement in chewing ability after RPD treatment. Pre-treatment impairment of chewing ability was associated with better responsiveness of the instruments.
仪器检测患者在接受修复治疗后报告的结局指标的临床重要变化的能力对于其在临床实践和研究环境中的使用至关重要。
本研究旨在前瞻性队列中评估仪器评估可摘局部义齿(RPD)治疗后患者对咀嚼能力感知的反应能力。
248 名部分无牙患者接受了 100mm 视觉模拟量表(VAS)、20 项食物摄入问卷(FIQ)和 6 分咀嚼困难量表(CDS)单项评估,以评估治疗前后的咀嚼能力。我们比较了治疗前后的评分,并确定了仪器对 RPD 治疗的效应量(r)。
VAS 和 CDS 均显示 RPD 治疗后咀嚼能力显著改善(P<0.05),但 FIQ 未显示(P=0.16),提示在控制性别、年龄、缺牙数和是否存在可摘义齿的情况下存在改善。VAS 的效应量为中等(r=0.54),CDS 的效应量为弱(r=0.14-0.17),FIQ 的效应量为无(r=-0.09)。r 的增加与治疗前咀嚼能力受损显著相关(ρ=-0.87,P<0.001)。
这些结果表明,100mm VAS 后,其次是 CDS,是检测 RPD 治疗后咀嚼能力改善最敏感的仪器。治疗前咀嚼能力受损与仪器的更好反应性相关。