Assessment of outcomes and cost-effectiveness in early orthodontic treatment

早期正畸治疗的结果和成本效益评估

• 批准号: 9063817
• 负责人: James J Chen
• 金额: $ 13.31万
• 依托单位: CHILDREN'S HOSPITAL & RES CTR AT OAKLAND
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-01 至 2019-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9063817
• 关键词: Adult; Aftercare; Award; Biostatistical Methods; Caring; Child; Childhood; Clinic; Clinical; Clinical Research; Clinical Trials; Communities; Cost Effectiveness Analysis; Cross Bite; Data; Decision Trees; Dental; Dental Care; Dental Insurance; Dentistry; Development; Diabetes Mellitus; Disadvantaged; Educational process of instructing; Enrollment; Evaluation; Family; Goals; Gold; Government; Health; Healthcare; Immigrant; Improve Access; Individual; Interceptive Orthodontics; Intervention Trial; K-Series Research Career Programs; Knowledge; Learning; Life; Linear Regressions; Literature; Low income; Malocclusion; Measures; Medical; Medicine; Mentored Patient-Oriented Research Career Development Award; Mentors; Minority; Mixed Dentition; Modeling; Oral health; Orthodontic; Orthodontics; Outcome; Outcome Assessment; Participant; Patients; Perception; Periodontitis; Population; Preventive; Protocols documentation; Provider; Public Health; Quality of life; Questionnaires; Recruitment Activity; Regression Analysis; Research; Research Design; Research Personnel; Research Project Grants; Research Support; Residencies; Rural; Rural Community; School Dentistry; Science; Self Perception; Staging; Tooth structure; Training; Treatment Cost; Treatment Protocols; Treatment outcome; United States; Universities; Washington; Work; base; career; clinical epidemiology; cost; cost effective; cost effectiveness; dental casting; design; evidence base; experience; health care economics; health disparity; indexing; novel; peer; permanent tooth; professor; public health relevance; research study; socioeconomics; standard care; tooth crowding; trial comparing

Abstract This is an application for a K23 Mentored Research Career Development Award for Dr. James Chen, an Assistant Professor and Orthodontist at UCSF. Dr. Chen is working to establish his research on early interceptive orthodontic treatment for socially disadvantaged children and his clinical expertise. This application is designed to provide the necessary mentoring, training, and research support Dr. Chen needs to become a successful independent investigator. Specifically, this award sets out to accomplish the following goals: (1) become an expert in patient-based early interceptive orthodontic treatment research; (2) to determine the equivalence in treatment outcome and child self-perception between a removable-appliance-based protocol and a fixed-appliance-based protocol; (3) to learn and implement advanced biostatistical methods in clinical research; (4) to learn and implement cost-effectiveness analysis models on early interceptive orthodontic treatment protocols; (5) to develop and grow a strong independent clinical research career; (6) to be a leader in access to orthodontic health care in the United States. In order for Dr. Chen to achieve these goals he will need support to design and implement his study. Dr. Chen has assembled a diverse mentoring team comprised of a primary mentor, Dr. George Taylor, who is the Department Chair of Preventive and Restorative Sciences and conducts public-health-related research on diabetes and periodontitis, and three co-mentors with one consultant: Dr. Greg Huang, Chair of Orthodontics at the University of Washington, who is an expert on evidenced based orthodontic research; Dr. James Kahn, Professor of Clinical Epidemiology in Medicine at UCSF, who is an expert on cost-effectiveness analysis and health care economics; Dr. Jing Cheng, Associate Professor in the School of Dentistry, who is an expert on study design and biostatistical analysis; and Dr. Gerald Nelson, Acting Chair of Division of Orthodontics at UCSF, will serve as a clinical consultant because of his extensive knowledge and experience with early interceptive orthodontic treatment. Oral health disparities and access to orthodontic care for socially disadvantaged children is a major concern in the United States. Dr. Chen's research will focus on critically analyzing a novel removable appliance based treatment protocol aimed at reducing orthodontic need while limiting the financial impact on low-income families compared to the existing fixed appliance based treatment protocol. The hypothesis of this study is that a treatment protocol based on using removable appliances provides the same treatment outcome but better cost-effectiveness than a traditional fixed-appliance protocol. The crux of this study will include comparing the differences in treatment outcome (AIM 1), measured by occlusal index scores (PAR Index and ICON Index), the differences in child self-perception measured by Child Perception Questionnaire (AIM 2) after orthodontic treatment, and the difference in cost-effectiveness (AIM 3) between the removable appliance only group and the fixed appliances only group. For all three aims, Dr. Chen will recruit participants beginning early interceptive orthodontic treatment at La Clinica Community Clinic and UCSF Orthodontic Residency Clinic and he will follow them to completion of their orthodontic treatment and then progression into full permanent dentition. This study will require sophisticated multiple linear regression analyses. This research will be the starting point for developing and initiating a large intervention trial comparing removable based appliance therapy to fixed appliance based therapy for socially disadvantaged children. Towards the end of this K23 award Dr. Chen will prepare and apply for a R34 award to develop the intervention trial followed by an application for an U01 clinical trial award.

抽象的 这是詹姆斯·陈（James Chen）博士的K23指导研究职业发展奖的申请 UCSF的助理教授和正畸医生。 Chen博士正在努力建立他的研究 对社会弱势儿童及其临床专业知识的截然矫正治疗。此应用程序 旨在提供必要的指导，培训和研究支持Chen博士需要成为一个 成功的独立研究员。具体而言，该奖项旨在实现以下目标：（1） 成为基于患者的早期拦截正畸治疗研究的专家； （2）确定 治疗结果和基于可移动适应性方案之间的儿童自我感知的等效性 以及基于固定适应性的协议； （3）在临床中学习和实施高级生物统计学方法 研究; （4）在早期截距正畸上学习和实施成本效益分析模型 治疗方案； （5）发展和发展强大的独立临床研究职业； （6）成为领导者 在美国获得正畸医疗保健。为了使Chen博士实现这些目标，他将 需要支持设计和实施他的研究。 Chen博士组建了一个多元化的指导团队 由一位主要导师乔治·泰勒（George Taylor）组成，他是预防和修复的系主任 科学并对公共卫生有关糖尿病和牙周炎的研究，以及三名与 一位顾问：华盛顿大学正畸主席Greg Huang博士，他是专家 基于正畸研究；詹姆斯·卡恩（James Kahn）博士，医学临床流行病学教授 UCSF，成本效益分析和卫生保健经济学专家；同事Jing Cheng博士 牙科学校的教授，他是研究设计和生物统计学分析专家；和博士 UCSF正畸科代理司主席Gerald Nelson将担任临床顾问 他通过早期截距正畸治疗的广泛知识和经验。 口腔健康差异和获得社会不利儿童的正畸护理是主要关注的问题 美国。 Chen博士的研究将侧重于批判性地分析一种基于新型的可移动设备 旨在减少正畸需求的治疗方案，同时限制对低收入的财务影响 家庭与现有的基于固定设备的治疗方案相比。这项研究的假设是 基于使用可移动设备的治疗方案提供了相同的治疗结果，但更好 成本效益比传统的固定适应性方案。这项研究的症结将包括比较 通过咬合指数得分（PAR指数和图标指数）测量的治疗结果差异（AIM 1）， 儿童自我感知的差异是通过儿童感知问卷衡量的（AIM 2）正畸之后 治疗以及仅可移动设备组之间的成本效益差异（目标3）和 仅固定电器组。对于所有三个目标，Chen博士将招募参与者 La Clinica社区诊所和UCSF正畸住院诊所的截取正畸治疗 他将跟随他们完成正畸治疗，然后逐渐永久发展 牙列。这项研究将需要复杂的多个线性回归分析。这项研究将是 开发和启动大型干预试验的起点，比较基于可移动的设备 针对社会不利儿童的固定疗法治疗。到这个K23的尽头 Chen博士奖将准备并申请R34奖项，以制定干预审判，然后是 申请U01临床试验奖。