Zhao Ming-Yu, Zeng Wen, Chan Sze Ngai, Du Jianhao, Rao Naman, Liu Taoran, Ming Wai-Kit
Department of Prosthodontics, State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, People's Republic of China.
Department of Orthodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, Guangdong, People's Republic of China.
Patient Prefer Adherence. 2024 Dec 6;18:2455-2467. doi: 10.2147/PPA.S475061. eCollection 2024.
The main treatment options offered to patients to choose from when restoring a single missing tooth include tooth-supported three-unit fixed partial dentures (FPDs) and implant-supported single crowns (ISCs). However, due to the heterogeneity of current studies, it is difficult to objectively compare these two treatment strategies. In this study, a discrete choice experiment (DCE) was used to quantify the preferences of individuals undergoing restoration treatment for single tooth loss.
The DCE questionnaire was disseminated in a "snowball" fashion, with data collected from participants aged 18-60. Five important attributes of treatment were selected: (1) treatment procedure, (2) treatment time, (3) cost, (4) five-year survival rate, and (5) five-year complication rate. A conditional logit model was employed to ascertain the direction of participants' preferences for specific attribute levels and to derive their willingness to pay (WTP) through the principle of marginal utility.
287 participants completed the questionnaire. The results of the questionnaire revealed that the five-year complication rate (42.42%) was the most important attribute, followed by cost (20.43%), five-year survival rate (14.23%), treatment time (13.44%), and treatment procedure (9.49%). Participants were willing to pay RMB$11076.2 (USD$1,772.2) to obtain a 10% extra reduction in the five-year complication rate, and RMB$7434.6 (USD$1,189.5) for a non-invasive treatment.
In the ranking of the relative importance of key factors affecting single missing tooth restoration, complication rates are most highly valued, suggesting that reducing the complication rate is a key issue to be addressed in prosthodontics. In addition, deriving the ranking of patients' concerns about key factors can help to improve doctor-patient communication and provide a reference for treatment technology development and medical decision-making.
在修复单颗缺失牙时，为患者提供的主要治疗选择包括牙支持式三单位固定局部义齿（FPD）和种植支持式单冠（ISC）。然而，由于当前研究的异质性，难以客观比较这两种治疗策略。在本研究中，采用离散选择实验（DCE）来量化单颗牙缺失修复治疗个体的偏好。
DCE问卷以“滚雪球”方式分发，收集18至60岁参与者的数据。选择了治疗的五个重要属性：（1）治疗程序，（2）治疗时间，（3）费用，（4）五年生存率，（5）五年并发症发生率。采用条件logit模型确定参与者对特定属性水平的偏好方向，并通过边际效用原则得出他们的支付意愿（WTP）。
287名参与者完成了问卷。问卷结果显示，五年并发症发生率（42.42%）是最重要的属性，其次是费用（20.43%）、五年生存率（14.23%）、治疗时间（13.44%）和治疗程序（9.49%）。参与者愿意支付11076.2元人民币（1772.2美元）以获得五年并发症发生率额外降低10%，愿意支付7434.6元人民币（1189.5美元）接受非侵入性治疗。
在影响单颗缺失牙修复的关键因素相对重要性排序中，并发症发生率最受重视，这表明降低并发症发生率是口腔修复学中要解决的关键问题。此外，得出患者对关键因素的关注排序有助于改善医患沟通，并为治疗技术发展和医疗决策提供参考。
