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Identification and appraisal of outcome measures used to evaluate hypodontia care: A systematic review.

Abstract Identification and appraisal of the outcome measures that have been used to evaluate hypodontia treatment and deliver services are essential for improving care. A lack of alignment between outcomes and patient values can limit the scope for patient-centered care. Our objectives were to identify and appraise the outcomes selected to evaluate hypodontia care.
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Mayor MeshTerms
Keywords
Journal Title american journal of orthodontics and dentofacial orthopedics : official publication of the american association of orthodontists, its constituent societies, and the american board of orthodontics
Publication Year Start




PMID- 29407495
OWN - NLM
STAT- MEDLINE
DCOM- 20180213
LR  - 20180213
IS  - 1097-6752 (Electronic)
IS  - 0889-5406 (Linking)
VI  - 153
IP  - 2
DP  - 2018 Feb
TI  - Identification and appraisal of outcome measures used to evaluate hypodontia
      care: A systematic review.
PG  - 184-194.e18
LID - S0889-5406(17)30862-4 [pii]
LID - 10.1016/j.ajodo.2017.10.010 [doi]
AB  - INTRODUCTION: Identification and appraisal of the outcome measures that have been
      used to evaluate hypodontia treatment and deliver services are essential for
      improving care. A lack of alignment between outcomes and patient values can limit
      the scope for patient-centered care. Our objectives were to identify and appraise
      the outcomes selected to evaluate hypodontia care. METHODS: Data sources included
      10 electronic databases and grey literature, searched using terms for hypodontia 
      and its treatment methods. Study eligibility included mixed study designs to
      ensure comprehensive identification of outcomes, excluding case reports and case 
      series with fewer than 10 participants and nonsystematic reviews. Participants
      and interventions involved people with hypodontia receiving any dental treatment 
      to manage their hypodontia. Simulated treatment, purely laboratory-based
      interventions, and future treatments still in development were excluded. Research
      outcomes were identified and synthesised into 4 categories: clinical indicators, 
      and patient-reported, clinician-reported, and lay-reported outcomes. No synthesis
      of efficacy data was planned, and consequently no methodologic quality appraisal 
      of the studies was undertaken. RESULTS: The search identified 497 abstracts, from
      which 106 eligible articles were retrieved in full. Fifty-six studies and 8
      quality-improvement reports were included. Clinical indicators were reported in
      49 studies (88%) including appearance, function, dental health, treatment
      longevity, treatment success and service delivery. Patient-reported outcomes were
      given in 22 studies (39%) including oral health-related quality of life,
      appearance, function, symptoms of temporomandibular dysfunction, and patient
      experience. Clinician-reported outcomes were limited to appearance. Variability
      was seen in the tools used for measuring outcomes. CONCLUSIONS: There is a lack
      of rationale and consistency in the selection of outcome measures used to
      evaluate hypodontia care. Outcomes are largely clinician and researcher-driven
      with little evidence of their relevance to patients. There was a paucity of
      outcomes measuring access to care, quality of care, and cost. Evidence from
      hypodontia research is clinician-focused and likely to have limited value to
      support patients during decision making. Attempts to synthesise the evidence base
      for translation into practice will be challenging. There is a need for a core
      outcomes set with a patient-centric approach to drive improvements in health
      services.
CI  - Copyright (c) 2017 American Association of Orthodontists. Published by Elsevier
      Inc. All rights reserved.
FAU - Barber, Sophy
AU  - Barber S
AD  - Department of Orthodontics, Leeds Teaching Hospitals NHS Trust, Leeds, United
      Kingdom. Electronic address: [email protected]
FAU - Bekker, Hilary L
AU  - Bekker HL
AD  - Leeds Institute of Health Sciences, University of Leeds, Leeds, United Kingdom.
FAU - Meads, David
AU  - Meads D
AD  - Leeds Institute of Health Sciences, University of Leeds, Leeds, United Kingdom.
FAU - Pavitt, Sue
AU  - Pavitt S
AD  - Department of School of Dentistry, University of Leeds, Leeds, United Kingdom.
FAU - Khambay, Balvinder
AU  - Khambay B
AD  - Department of Orthodontics, University of Birmingham, Birmingham, United Kingdom.
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Am J Orthod Dentofacial Orthop
JT  - American journal of orthodontics and dentofacial orthopedics : official
      publication of the American Association of Orthodontists, its constituent
      societies, and the American Board of Orthodontics
JID - 8610224
SB  - D
SB  - IM
MH  - Anodontia/*therapy
MH  - Dental Care/methods/*standards
MH  - Humans
MH  - Quality Assurance, Health Care/*methods/standards
MH  - Treatment Outcome
EDAT- 2018/02/07 06:00
MHDA- 2018/02/14 06:00
CRDT- 2018/02/07 06:00
PHST- 2017/02/01 00:00 [received]
PHST- 2017/10/01 00:00 [revised]
PHST- 2017/10/01 00:00 [accepted]
PHST- 2018/02/07 06:00 [entrez]
PHST- 2018/02/07 06:00 [pubmed]
PHST- 2018/02/14 06:00 [medline]
AID - S0889-5406(17)30862-4 [pii]
AID - 10.1016/j.ajodo.2017.10.010 [doi]
PST - ppublish
SO  - Am J Orthod Dentofacial Orthop. 2018 Feb;153(2):184-194.e18. doi:
      10.1016/j.ajodo.2017.10.010.