Developing outcome measures in orthodontics that reflect patient and provider values.
During the past decade, emphasis in orthodontics has been directed toward the development of outcome measures from both the patient and clinician perspectives. New methodological standards of rigor have been introduced into research design to eliminate bias and test well-defined questions. Sample size calculations and established exclusion and inclusion criteria define sample populations and the ability to statistically accept or reject hypothesis-driven clinical studies. Although advances in our understanding of evidence-based medicine and dentistry from the provider perspective have been productive, the emerging value placed on patient perspective has not been as forthcoming. The emphasis placed on patient-oriented clinical research has resulted in new constructs of surveys and questionnaires in which the items are derived and tested from the patient's point of view. Because orthodontics is a condition without the natural history of a disease process for which no intervention has predictable consequences, new strategies have been developed to estimate need and demand for orthodontic treatment. Studies to measure seekers and nonseekers of orthodontic treatment are reported, as well as sex and cross-cultural issues in the use of established process and outcome measures. The design of clinical studies is discussed in the context of future directions for clinical research, and the usefulness of the information generated will directly relate to providing patients with the necessary information to make decisions and hence knowledgeably give informed consent for treatment interventions.
Vig
K W
KW
Orthodontic Department, College of Dentistry, Ohio State University, Columbus 43210-1241, USA.
Weyant
R
R
O'Brien
K
K
Bennett
E
E
D002986:Clinical Trials as Topic / Q000379:methods; D018865:Dental Research / Q000379:methods; D019317:Evidence-Based Medicine; D006801:Humans; D008310:Malocclusion / Q000175:diagnosis* / Q000453:epidemiology; D020380:Needs Assessment; D009970:Orthodontics / Q000706:statistics & numerical data*; D017063:Outcome Assessment, Health Care / Q000379:methods*; D010342:Patient Acceptance of Health Care; D017060:Patient Satisfaction; D018802:Patient-Centered Care; D012945:Social Values