Stephens C D, Drage K J, Richmond S, Shaw W C, Roberts C T, Andrews M
Department of Child Dental Health, University of Bristol Dental School, UK.
J Dent. 1993 Dec;21(6):355-9. doi: 10.1016/0300-5712(93)90011-e.
Prior to 1987, dental practitioners in England and Wales intending to carry out all but the simplest orthodontic treatment within the National Health Service, were required to submit pretreatment study models, details of the orthodontic assessment and the proposed treatment plan to the Dental Estimates Board prior to starting treatment. Models taken at the end of treatment were required by the Board to enable payment to be made. In this pilot study, the acceptability of orthodontic treatment plans used by practitioners working in the General Dental Services was assessed by eight hospital consultants, using information about 40 cases submitted to the Dental Estimates Board in 1987/88. All consultants considered a high proportion of plans to be unacceptable, but agreement between the consultants was variable and some agreed with one another on very few plans. A single scorer used the weighted PAR (Peer Assessment Rating) index to assess the degree of departure from normal occlusion of both pre- and post-treatment models. Using accepted standards, only nine cases were greatly improved (PAR reduction > 70%) and the mean percentage reduction in PAR score was low. Consultant opinion on the appropriateness of treatment planning was not related to the outcome of orthodontic treatment.
1987年以前，在英格兰和威尔士，国民医疗服务体系内除了最简单的正畸治疗外，其他正畸治疗的从业者在开始治疗前，需要向牙科评估委员会提交治疗前研究模型、正畸评估细节和拟议的治疗计划。委员会要求提交治疗结束时的模型以便进行费用支付。在这项试点研究中，八位医院顾问利用1987/88年提交给牙科评估委员会的40个病例的信息，对在一般牙科服务中工作的从业者使用的正畸治疗计划的可接受性进行了评估。所有顾问都认为很大一部分计划不可接受，但顾问之间的意见一致性各不相同，有些顾问在极少数计划上达成了一致。一位评分员使用加权PAR（同行评估等级）指数来评估治疗前和治疗后模型与正常咬合的偏离程度。按照公认的标准，只有9个病例有显著改善（PAR降低>70%），PAR评分的平均降低百分比很低。顾问对治疗计划适当性的意见与正畸治疗的结果无关。
