Burden D J, Garvin W, Patterson C C
Orthodontic Division, Queen's University of Belfast.
Br Dent J. 1997 Aug 23;183(4):123-9. doi: 10.1038/sj.bdj.4809442.
To evaluate whether GDPs using an index of Orthodontic Treatment Need (IOTN) learning package in a practice setting referred (or treated) more patients with a definite need for orthodontic treatment.
A randomised controlled trial.
20 GDPs (test group) used the package when selecting patients for orthodontic care during normal dental practice. A control group of 20 GDPs did not use the package. Over a 12-month period impressions were taken by the participating GDPs of all patients selected for orthodontic treatment, either referred to another practitioner or to be treated by the GDP.
IOTN used by two expert examiners.
Among the patients selected for orthodontic treatment by the test group there were more patients with a definite objective need for orthodontic treatment (78.1% versus 62.5% in the control group). After adjustment for potential confounding variables, the odds on a patient selected by a test group dentist being in definite need were 2.24 (95% CI 1.25, 4.01) more than the odds on a patient selected by a control group dentist (P = 0.007).
Use of the IOTN learning package by GDPs would reduce the proportion of patients selected for orthodontic treatment with low or moderate objective need.
评估在实际临床环境中使用正畸治疗需求指数（IOTN）学习包的全科牙医（GDPs）是否会转诊（或治疗）更多确实需要正畸治疗的患者。
一项随机对照试验。
20名全科牙医（试验组）在正常牙科诊疗过程中为正畸治疗挑选患者时使用该学习包。20名全科牙医组成的对照组不使用该学习包。在12个月的时间里，参与研究的全科牙医为所有被选作正畸治疗的患者取模，这些患者要么被转诊给其他医生，要么由该全科牙医进行治疗。
两名专家检查者使用的IOTN。
试验组挑选的正畸治疗患者中，确实有正畸治疗客观需求的患者更多（试验组为78.1%，对照组为62.5%）。在对潜在混杂变量进行调整后，试验组牙医挑选的患者有明确需求的几率比对照组牙医挑选的患者高2.24倍（95%可信区间为1.25, 4.01）（P = 0.007）。
全科牙医使用IOTN学习包将减少被选作正畸治疗但客观需求较低或中等的患者比例。
