Brickley M, Kay E, Shepherd J
Department of Oral Surgery, Medicine and Pathology, University of Wales College of Medicine, Cardiff, UK.
Community Dent Health. 1995 Jun;12(2):70-6.
Disease associated with third molars is being recognised increasingly as a public health problem in terms both of rising incidence and of appropriate use of resources. Since minor alterations in treatment philosophy can have a substantial impact on the efficiency and effectiveness of oral surgery services, this study examines the sensitivity and specificity of oral surgeons' decisions and uses Receiver Operator Characteristics (ROC) analysis to investigate their ability to detect and make appropriate judgements about teeth which need extraction according to established criteria. The study shows that the seniority of the surgeon making the treatment decisions had no significant effect on the decisions made and also demonstrated wide variations between the treatment plans made by individual clinicians. It is clear from this study that if an efficient and effective service for the treatment of third molar disease is to be commissioned, policy decisions about criteria for intervention must be made by health service purchasing authorities, adhered to by secondary care providers, and shared with the primary care practitioners who refer patients for treatment.
与第三磨牙相关的疾病，无论是从发病率上升还是从资源的合理利用来看，都日益被视为一个公共卫生问题。由于治疗理念上的微小变化可能会对口腔外科服务的效率和效果产生重大影响，本研究考察了口腔外科医生决策的敏感性和特异性，并使用受试者操作特征（ROC）分析来研究他们根据既定标准检测并对需要拔除的牙齿做出适当判断的能力。研究表明，做出治疗决策的外科医生的资历对所做决策没有显著影响，并且还表明个别临床医生制定的治疗方案之间存在很大差异。从这项研究中可以清楚地看出，如果要提供高效且有效的第三磨牙疾病治疗服务，卫生服务采购当局必须做出关于干预标准的政策决策，二级医疗服务提供者必须遵守这些决策，并与将患者转诊进行治疗的初级医疗从业者共享这些决策。
