Kay E J, Locker D
Department of Oral Health and Development, Tumer Dental School University of Manchester, England.
Community Dent Oral Epidemiol. 1996 Aug;24(4):231-5. doi: 10.1111/j.1600-0528.1996.tb00850.x.
In order that health service resources are allocated in the way which most benefits the population, systematic review of the available evidence regarding the effectiveness of programmes and interventions are required. This study examined papers relating to dental health education interventions, which were published between 1982 and 1994 (n = 143). Each was scored by two independent researchers according to twenty predetermined validity criteria. For each paper which achieved a validity score of more than 12 (n = 37), data concerning the objectives of the intervention, the types and numbers of participants, and the outcomes, were extracted from the article. Where sufficient data were provided in a paper which met more than 15 of the validity criteria quantitative meta-analysis was carried out i.e. the results of the studies were pooled in order to calculate an overall intervention effect with confidence intervals. This combination of qualitative and quantitative review techniques showed that dental health interventions have: a small positive, but temporary effect on plaque accumulation (reduction in plaque index = 0.37 95% CI -0.29-0.59); no discernible effect on caries increment and a consistent positive effect on knowledge levels. The results of this analysis suggest that further efforts to synthesise current information about dental health education, in a systematic way, are required, along with maintenance of rigorous scientific standards in evaluation research.
为了使卫生服务资源以最有利于民众的方式进行分配，需要对有关项目和干预措施有效性的现有证据进行系统评价。本研究调查了1982年至1994年间发表的与牙齿健康教育干预措施相关的论文（n = 143）。每篇论文由两名独立研究人员根据二十项预先确定的有效性标准进行评分。对于每篇有效性得分超过12分的论文（n = 37），从文章中提取有关干预目标、参与者类型和数量以及结果的数据。如果一篇符合超过15项有效性标准的论文提供了足够的数据，则进行定量荟萃分析，即汇总研究结果以计算具有置信区间的总体干预效果。这种定性和定量综述技术相结合的方法表明，牙齿健康干预措施具有：对牙菌斑积聚有小的积极但暂时的影响（牙菌斑指数降低 = 0.37，95%可信区间 -0.29 - 0.59）；对龋齿增加没有明显影响，对知识水平有一致的积极影响。该分析结果表明，需要进一步努力以系统的方式综合当前有关牙齿健康教育的信息，同时在评价研究中保持严格的科学标准。
