Developing a Standard Set of Patient-centred Outcomes for Adult Oral Health - An International, Cross-disciplinary Consensus

Richeal Ni Riordain; Michael Glick; Shiamaa Shihab Ahmed Al Mashhadani; Krishna Aravamudhan; Jane Barrow; Deborah Cole; James J Crall; Jennifer E Gallagher; Jacqui Gibson; Shalika Hegde; Rebekah Kaberry; Elsbeth Kalenderian; Anup Karki; Roger Keller Celeste; Stefan Listl; Stacie N Myers; Richard Niederman; Tania Severin; Mark W Smith; W Murray Thomson; Georgios Tsakos; Marko Vujicic; Richard G Watt; Sarah Whittaker; David M Williams

doi:10.1111/idj.12604

Developing a Standard Set of Patient-centred Outcomes for Adult Oral Health - An International, Cross-disciplinary Consensus

Int Dent J. 2021 Feb;71(1):40-52. doi: 10.1111/idj.12604. Epub 2021 Jan 16.

Authors

Richeal Ni Riordain¹, Michael Glick², Shiamaa Shihab Ahmed Al Mashhadani³, Krishna Aravamudhan⁴, Jane Barrow⁵, Deborah Cole⁶, James J Crall⁷, Jennifer E Gallagher⁸, Jacqui Gibson⁹, Shalika Hegde¹⁰, Rebekah Kaberry⁹, Elsbeth Kalenderian¹¹, Anup Karki¹², Roger Keller Celeste¹³, Stefan Listl¹⁴, Stacie N Myers¹⁵, Richard Niederman¹⁶, Tania Severin¹⁷, Mark W Smith¹⁸, W Murray Thomson¹⁹, Georgios Tsakos²⁰, Marko Vujicic⁴, Richard G Watt²¹, Sarah Whittaker¹⁵, David M Williams²²

Affiliations

¹ ICHOM Adult Oral Health Working Group, Boston, MA, USA; University College London, London, UK; University College Cork, Cork, Ireland. Electronic address: [email protected].
² ICHOM Adult Oral Health Working Group, Boston, MA, USA; FDI Vision 2020 Think Tank, Geneva, Switzerland; School of Dental Medicine, University at Buffalo, Buffalo, NY, USA.
³ ICHOM Adult Oral Health Working Group, Boston, MA, USA; Dubai Health Authority, Dubai, UAE.
⁴ ICHOM Adult Oral Health Working Group, Boston, MA, USA; American Dental Association, Chicago, IL, USA.
⁵ ICHOM Adult Oral Health Working Group, Boston, MA, USA; Harvard School of Dental Medicine, Boston, MA, USA.
⁶ ICHOM Adult Oral Health Working Group, Boston, MA, USA; Dental Health Services Victoria, Melbourne, Vic., Australia.
⁷ ICHOM Adult Oral Health Working Group, Boston, MA, USA; UCLA School of Dentistry, Los Angeles, CA, USA.
⁸ ICHOM Adult Oral Health Working Group, Boston, MA, USA; King's College London, London, UK.
⁹ ICHOM Adult Oral Health Working Group, Boston, MA, USA.
¹⁰ Dental Health Services Victoria, Melbourne, Vic., Australia.
¹¹ ICHOM Adult Oral Health Working Group, Boston, MA, USA; UCSF School of Dentistry, San Francisco, CA, USA.
¹² ICHOM Adult Oral Health Working Group, Boston, MA, USA; Public Health Wales, Cardiff, UK.
¹³ ICHOM Adult Oral Health Working Group, Boston, MA, USA; Federal University of Rio Grande do Sol, Porto Alegre, Grande do Sul, Brazil.
¹⁴ ICHOM Adult Oral Health Working Group, Boston, MA, USA; FDI Vision 2020 Think Tank, Geneva, Switzerland; Department of Conservative Dentistry, Heidelberg University Clinics, Heidelberg, Germany; Department of Dentistry - Quality and Safety of Oral Health Care, Radboud University - Radboudumc (RIHS), Nijmegen, The Netherlands.
¹⁵ International Consortium for Health Outcomes Measurement (ICHOM), Boston, MA, USA.
¹⁶ ICHOM Adult Oral Health Working Group, Boston, MA, USA; NYU College of Dentistry, New York, NY, USA.
¹⁷ FDI World Dental Federation (FDI), Geneva, Switzerland.
¹⁸ ICHOM Adult Oral Health Working Group, Boston, MA, USA; Hospitals Contribution Fund, Sydney, NSW, Australia.
¹⁹ ICHOM Adult Oral Health Working Group, Boston, MA, USA; University of Otago, Dunedin, New Zealand.
²⁰ ICHOM Adult Oral Health Working Group, Boston, MA, USA; University College London, London, UK; FDI Vision 2020 Think Tank, Geneva, Switzerland.
²¹ University College London, London, UK; FDI Vision 2020 Think Tank, Geneva, Switzerland.
²² ICHOM Adult Oral Health Working Group, Boston, MA, USA; FDI Vision 2020 Think Tank, Geneva, Switzerland; Bart's and The London, School of Medicine and Dentistry, Queen Mary, University of London, London, UK.

Abstract

Objective: To develop a minimum Adult Oral Health Standard Set (AOHSS) for use in clinical practice, research, advocacy and population health.

Materials and methods: An international oral health working group (OHWG) was established, of patient advocates, researchers, clinicians and public health experts to develop an AOHSS. PubMed was searched for oral health clinical and patient-reported measures and case-mix variables related to caries and periodontal disease. The selected patient-reported outcome measures focused on general oral health, and oral health-related quality of life tools. A consensus was reached via Delphi with parallel consultation of subject matter content experts. Finally, comments and input were elicited from oral health stakeholders globally, including patients/consumers.

Results: The literature search yielded 1,453 results. After inclusion/exclusion criteria, 959 abstracts generated potential outcomes and case-mix variables. Delphi rounds resulted in a consensus-based selection of 80 individual items capturing 31 outcome and case-mix concepts. Global reviews generated 347 responses from 87 countries, and the patient/consumer validation survey elicited 129 responses. This AOHSS includes 25 items directed towards patients (including demographics, the impact of their oral health on oral function, a record of pain and oral hygiene practices, and financial implications of care) and items for clinicians to complete, including medical history, a record of caries and periodontal disease activity, and types of dental treatment delivered.

Conclusion: In conclusion, utilising a robust methodology, a standardised core set of oral health outcome measures for adults, with a particular emphasis on caries and periodontal disease, was developed.

Keywords: Oral health; Outcome measures; Patient outcome assessment; Quality of life.

MeSH terms

Adult
Consensus
Delphi Technique
Humans
Oral Health*
Outcome Assessment, Health Care
Quality of Life*
Reference Standards