Locker D
Faculty of Dentistry, University of Toronto, Ontario, Canada.
Community Dent Oral Epidemiol. 1998 Feb;26(1):41-7. doi: 10.1111/j.1600-0528.1998.tb01923.x.
An important goal of a health care intervention or system is to improve the health of an individual or a population. The challenge for health services research is to measure and explain this change. However, the issue of how changes in health status should be defined and measured has been given relatively little attention. This paper draws on the rather sparse literature to examine some issues involved in measuring changes in oral health status and illustrates these using data from a longitudinal study of the oral health of older adults. The paper draws a distinction between quantitative and qualitative change and the challenges involved with each. Four different ways of assessing change are reviewed and their strengths and weaknesses highlighted. Global transition judgements, although relatively simple measures of change, incorporate patients' values and avoid the statistical problems associated with measures such as change scores. Nevertheless, the measurement of change in oral health status is complex and controversial and no approach is universally accepted. Consequently, the decision as to which strategy to adopt is far from simple.
医疗保健干预措施或系统的一个重要目标是改善个人或人群的健康状况。卫生服务研究面临的挑战是衡量并解释这种变化。然而，健康状况变化应如何定义和衡量这一问题却相对较少受到关注。本文借鉴了颇为稀少的文献，探讨衡量口腔健康状况变化所涉及的一些问题，并利用一项针对老年人口腔健康的纵向研究数据进行说明。本文区分了定量变化和定性变化以及各自所涉及的挑战。回顾了评估变化的四种不同方法，并突出了它们的优缺点。整体转变判断尽管是相对简单的变化衡量方法，但纳入了患者的价值观，且避免了与变化分数等测量方法相关的统计问题。尽管如此，口腔健康状况变化的测量既复杂又具有争议性，没有一种方法得到普遍认可。因此，决定采用哪种策略绝非易事。
