Section of Oral Rehabilitation, Department of Odontology, Faculty of Health Sciences, University of Copenhagen, København, Denmark.
Periodontol 2000. 2023 Oct;93(1):270-276. doi: 10.1111/prd.12500. Epub 2023 Jul 26.
Evidence-based dentistry used for decision-making and assessment of treatment includes three components: evidence from the literature, clinical expertise, and patient expectations. Patient satisfaction embraces affability, availability, and ability and can be examined using questionnaires or structured questions to the patient to evaluate patient perception of the treatment. The questions can be quantified using dichotomous, point, or visual analog scales. This would be a straightforward patient-reported outcome measure (PROM). Validated and specific oral health-related quality of life (OHRQoL) questionnaires such as the oral health impact profile (OHIP), oral impact on daily performance (OIDP), or the dental impact on daily living (DIDL) can be used as PROMs, and these measures are appropriate for population studies, where you can measure changes over time and differences between treatment groups. PROMs have shown to enhance patient engagement when integrated into clinical care. PROMs for bone regenerative procedures are mainly used as secondary outcome and are concentrating on the prosthetic outcome more than the pain, discomfort, anxiety, and cost of the surgical procedures. Surprisingly, most patients are satisfied and willing to have the procedures performed again. Whether this is recall bias or not and how the information's from the dentist and the team influence the patients answers to PROMs questionnaires are discussed. The importance of patient perspectives in bone regeneration procedures is obvious and combined with clinical outcome measures, it increases our ability to provide better care. Studies using PROMs as a primary outcome variable are required.
文献证据、临床专业知识和患者期望。患者满意度包括友善、可用性和能力,可以通过问卷或向患者提出结构化问题来评估患者对治疗的看法。可以使用二项式、点或视觉模拟量表来对问题进行量化。这将是一种直接的患者报告结局测量(PROM)。可以使用经过验证和特定的口腔健康相关生活质量(OHRQoL)问卷,如口腔健康影响量表(OHIP)、日常口腔影响量表(OIDP)或日常生活中的牙科影响量表(DIDL)作为 PROM,这些措施适用于人群研究,可以测量随时间的变化和治疗组之间的差异。将 PROM 纳入临床护理可以提高患者的参与度。骨再生程序的 PROM 主要用作次要结局,更关注修复体的效果,而不是手术的疼痛、不适、焦虑和成本。令人惊讶的是,大多数患者都很满意,并愿意再次接受这些手术。不知道这是否是回忆偏差,以及牙医和团队的信息如何影响患者对 PROM 问卷的回答,这些问题都有待讨论。患者对骨再生手术的看法很重要,结合临床结局测量,这可以提高我们提供更好护理的能力。需要进行使用 PROM 作为主要结果变量的研究。