Hettiarachchi Ruvini M, Kularatna Sanjeewa, Byrnes Joshua, Chen Gang, Mulhern Brendan, Scuffham Paul A
Centre for Applied Health Economics, School of Medicine and Menzies Health Institute Queensland, Griffith University, Griffith, Queensland, Australia.
Australian Centre for Health Services Innovation (AusHSI) and Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, Queensland, Australia.
J Public Health Dent. 2022 Jun;82(3):253-261. doi: 10.1111/jphd.12490. Epub 2021 Dec 2.
Preference-based quality-of-life measures (PBMs) have been developed in many clinical areas to aid estimation of more accurate utility values for economic evaluations. Existing oral health-related quality-of-life (OHRQoL) instruments are non-PBM and hence, cannot be used to generate utility values. The objective of this study was to develop a classification system for a new PBM (dental caries utility index-DCUI) for the most prevalent childhood oral health condition: dental caries.
Possible domains and items to be included in the classification system were identified based on the reviewing available pediatric non-PBM OHRQoL instruments, studies eliciting utility values for oral health outcomes and clinical dentistry textbooks and based on the findings, a draft classification system was developed. To refine the draft classification system, semi-structured interviews were conducted among a convenience sample of 15 12-17-year-old adolescents who had experience with dental caries. The classification system was further refined and validated by a group of dental experts, using a modified Delphi technique.
The classification system comprised five items (pain/discomfort, difficulty in eating food/drinking, worried, ability to participate in activities, and appearance) and each item had a four-level response scale.
The classification system developed herein is considered an amenable tool for the subsequent development of a new PBM for dental caries. Once the scoring algorithm is completed, the classification system can be used to incorporate economic evaluations of dental caries health interventions.
在许多临床领域已开发出基于偏好的生活质量测量方法(PBMs),以帮助为经济评估估算更准确的效用值。现有的口腔健康相关生活质量(OHRQoL)工具并非基于偏好,因此不能用于生成效用值。本研究的目的是为最常见的儿童口腔健康状况——龋齿,开发一种新的基于偏好的生活质量测量方法(龋齿效用指数-DCUI)的分类系统。
基于对现有的儿科非基于偏好的OHRQoL工具、引出口腔健康结果效用值的研究以及临床牙科教科书的回顾,确定分类系统中可能包含的领域和项目,并据此制定了分类系统草案。为完善分类系统草案,对15名有龋齿经历的12 - 17岁青少年进行了便利抽样的半结构化访谈。一组牙科专家使用改良的德尔菲技术对分类系统进行了进一步完善和验证。
分类系统包括五个项目(疼痛/不适、进食/饮水困难、担忧、参与活动的能力和外观),每个项目有四级反应量表。
本文开发的分类系统被认为是后续开发龋齿新的基于偏好的生活质量测量方法的适用工具。一旦完成评分算法,该分类系统可用于纳入龋齿健康干预措施的经济评估。