Initial development of an 'Orthodontic Care Index' involving treatment need,-complexity and-priority.

diagnosis and treatment planning early treatment orthodontic index

Journal

European journal of orthodontics
ISSN: 1460-2210
Titre abrégé: Eur J Orthod
Pays: England
ID NLM: 7909010

Informations de publication

Date de publication:
01 Jan 2024
Historique:
medline: 10 1 2024
pubmed: 10 1 2024
entrez: 9 1 2024
Statut: ppublish

Résumé

The aim of this study was to develop an evidence-based scoring system for prioritizing limited orthodontic resources based on orthodontic treatment need (OTN), orthodontic treatment complexity (OTC), and orthodontic treatment priority (OTP), which is not merely a scoring system for malocclusion but also a comprehensive classification of orthodontic issues incorporating patient- and treatment-related factors, called Orthodontic Care Index (OCI). The development of the OCI involved eight phases, starting with a systematic literature review to identify all possible parameters involved in determining OTN, OTC, and OTP. An eight-member orthodontic specialist panel then evaluated and scored the significance of each parameter, resulting in a parameter-score list. Subsequently, a retrospective convenience sample of 61 patients was scored with the parameter-score list, and using the same convenience sample a gold standard was established through the expert opinion of a third orthodontic panel. Linear regression analysis was used to estimate weights of importance and construct a formula to calculate index scores. Lastly, the expert opinion was compared to the index scores, to determine the index performance. The preliminary index separately calculates OTN, OTC, and OTP for a patient as the weighted sum of his/her domain scores. The sensitivity of the index for predicting OTN, OTC, and OTP was high (98.1%, 82.9%, and 92.7% respectively), while the variability of each was relatively low (52.1%, 31.2%, and 52.6% respectively). The OCI shows promise as a guideline for prioritizing orthodontic care. It will be further refined and validated to enhance its performance and usefulness.

Sections du résumé

BACKGROUND/OBJECTIVES OBJECTIVE
The aim of this study was to develop an evidence-based scoring system for prioritizing limited orthodontic resources based on orthodontic treatment need (OTN), orthodontic treatment complexity (OTC), and orthodontic treatment priority (OTP), which is not merely a scoring system for malocclusion but also a comprehensive classification of orthodontic issues incorporating patient- and treatment-related factors, called Orthodontic Care Index (OCI).
MATERIALS AND METHODS METHODS
The development of the OCI involved eight phases, starting with a systematic literature review to identify all possible parameters involved in determining OTN, OTC, and OTP. An eight-member orthodontic specialist panel then evaluated and scored the significance of each parameter, resulting in a parameter-score list. Subsequently, a retrospective convenience sample of 61 patients was scored with the parameter-score list, and using the same convenience sample a gold standard was established through the expert opinion of a third orthodontic panel. Linear regression analysis was used to estimate weights of importance and construct a formula to calculate index scores. Lastly, the expert opinion was compared to the index scores, to determine the index performance.
RESULTS RESULTS
The preliminary index separately calculates OTN, OTC, and OTP for a patient as the weighted sum of his/her domain scores. The sensitivity of the index for predicting OTN, OTC, and OTP was high (98.1%, 82.9%, and 92.7% respectively), while the variability of each was relatively low (52.1%, 31.2%, and 52.6% respectively).
CONCLUSIONS/IMPLICATIONS CONCLUSIONS
The OCI shows promise as a guideline for prioritizing orthodontic care. It will be further refined and validated to enhance its performance and usefulness.

Identifiants

pubmed: 38195094
pii: 7513424
doi: 10.1093/ejo/cjad082
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© The Author(s) 2024. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Auteurs

Lutgart De Ridder (L)

Department of Oral Health Sciences-Orthodontics, KU Leuven, University Hospitals Leuven, Kapucijnenvoer 7, Blok 1, Bus 7001, 3000 Leuven, Belgium.

Julie Decreus (J)

Department of Oral Health Sciences-Orthodontics, KU Leuven, University Hospitals Leuven, Kapucijnenvoer 7, Blok 1, Bus 7001, 3000 Leuven, Belgium.

Guy Willems (G)

Department of Oral Health Sciences-Orthodontics, KU Leuven, University Hospitals Leuven, Kapucijnenvoer 7, Blok 1, Bus 7001, 3000 Leuven, Belgium.

Maria Cadenas de Llano-Pérula (M)

Department of Oral Health Sciences-Orthodontics, KU Leuven, University Hospitals Leuven, Kapucijnenvoer 7, Blok 1, Bus 7001, 3000 Leuven, Belgium.

Classifications MeSH