Spetz Joanne, Rose Johnie, Kahn James G, Lin Tracy, Levy Douglas, Pugach Oksana, Hyde Susan, Borrelli Belinda, Henshaw Michelle, Martin Molly, Nelson Suchitra, Ramos-Gomez Francisco, Gansky Stuart A
Philip R. Lee Institute for Health Policy Studies and Healthforce Center, University of California, San Francisco, CA, United States.
Center for Community Health Integration, Case Western Reserve University School of Medicine, Cleveland, OH, United States.
Front Oral Health. 2024 Jul 18;5:1428638. doi: 10.3389/froh.2024.1428638. eCollection 2024.
In 2015, the National Institute of Dental and Craniofacial Research (NIDCR) launched the Multidisciplinary Collaborative Research Consortium to Reduce Oral Health Disparities in Children, supporting four randomized trials testing strategies to improve preventive care. A Coordinating Center provides scientific expertise, data acquisition and quality assurance services, safety monitoring, and final analysis-ready datasets. This paper describes the trials' economic analysis strategies, placing these strategies within the broader context of contemporary economic analysis methods.
The Coordinating Center established a Cost Collaborative Working Group to share information from the four trials about the components of their economic analyses. Study teams indicated data sources for their economic analysis using a set of structured tables. The Group meets regularly to share progress, discuss challenges, and coordinate analytic approaches.
All four trials will calculate incremental cost-effectiveness ratios; two will also conduct cost-utility analyses using proxy diseases to estimate health state utilities. Each trial will consider at least two perspectives. Key process measures include dental services provided to child participants. The non-preference-weighted Early Childhood Oral Health Impact Scale (ECOHIS) will measure oral health-related quality of life. All trials are measuring training, implementation, personnel and supervision, service, supplies, and equipment costs.
Consistent with best practices, all four trials have integrated economic analysis during their planning stages. This effort is critical since poor quality or absence of essential data can limit retrospective analysis. Integrating economic analysis into oral health preventive intervention research can provide guidance to clinicians and practices, payers, and policymakers.
2015年，美国国立牙科和颅面研究所（NIDCR）发起了多学科合作研究联盟，以减少儿童口腔健康差异，资助了四项随机试验来测试改善预防保健的策略。一个协调中心提供科学专业知识、数据采集和质量保证服务、安全监测以及最终可供分析的数据集。本文描述了这些试验的经济分析策略，并将这些策略置于当代经济分析方法的更广泛背景中。
协调中心成立了成本协作工作组，以分享四项试验中有关其经济分析组成部分的信息。研究团队使用一组结构化表格指出其经济分析的数据来源。该小组定期开会，分享进展、讨论挑战并协调分析方法。
所有四项试验都将计算增量成本效益比；两项试验还将使用替代疾病进行成本效用分析，以估计健康状态效用。每项试验将至少考虑两个视角。关键过程指标包括向儿童参与者提供的牙科服务。非偏好加权的幼儿口腔健康影响量表（ECOHIS）将衡量与口腔健康相关的生活质量。所有试验都在衡量培训、实施、人员和监督、服务、用品及设备成本。
与最佳实践一致，所有四项试验在规划阶段都纳入了经济分析。这项工作至关重要，因为数据质量差或缺乏关键数据会限制回顾性分析。将经济分析纳入口腔健康预防干预研究可为临床医生、医疗机构、支付方和政策制定者提供指导。
