Background
Aim of the study
Scientific hypothesis
Methods
Study design
Intervention | CPG | |
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ROE | MIM | |
Group I (ROE) | Intervention | Control |
Group II (MIM) | Control | Intervention |
Recruitment of GDPs and inclusion/exclusion criteria
GDP inclusion criteria
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GDPs who work for at least for three days a week in general dental practice for a minimum of three years
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GDPs who have a patient population of regular ROE-attendees and manage their patient records electronically.
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GDPs were required to give their informed consent for the assessment and evaluation of electronic patient records. Patient data are collected anonymously.
Patient's inclusion criteria
Patient's exclusion criteria
Intervention
Implementation strategy
Interventions for all IQualgroups | ||
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Composition IQual group Introductory letter (individual) Delivery registration forms and questionnaires | Questionnaire GDPs 25 observations chair side | |
Randomisation
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Interventions trial arms
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ROE group I
|
MIM group II
|
Delivery CPG on ROE versus MIM by post | CPG ROE | CPG MIM |
Education session IQual group | ROE education | MIM education |
Online training website (individual feed back) | Access to ROE-based training | Access to MIM-based training |
Reminder (flow chart), individual feed back record form Feed back by email | ROE- aspects Flow chart | MIM-aspects Flow chart |
Registration in practice (25) | 25 observations in practice chair side | 25 observations in practice chair side |
End trial | Questionnaire | Questionnaire |
Randomisation
Outcomes and instruments
ROE study
Outcome parameter | Instruments | |
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Primary ROE-outcomes
| Clinical Performance/decision-making: Number of patients per GDP with assigned recall interval (months) based on individual risk profile assessment. For high-risk children and adolescents' intervals less than seven months, in case of low risk profile more than seven months; for low-risk adults' profiles, nine months equal or more, and for high-risk adults' profiles less than nine months. |
Patient record, registration form, to analyse risk management
|
Secondary ROE-outcomes
| Clinical Performance/decision-making: Number of patients per GDP with prescribed individual frequency of BWs (months). For high-risk children and adolescents, frequencies of less than 24 months, and for low-risk profiles, frequencies of more than 36 months; for high-risk adults, prescription frequencies less than 36 months, and for low risk adults, prescription of more than 48 months. Number of patients per GDP with periodontal DPSI-score > 1, and prevalent caries, who have been given feedback, information and preventive advice, registered in patient record or registration form. Efficacy data/cost-effectiveness scores: Mean overall length in months of recall intervals per GDP over the past 3 yrs Mean total number of BW(s) and other radiographs over past 3 years Type of performer GDP/Oral hygienist/others (level of graduation, education) Total number of additional interventions performed during ROE (polishing, removal of calculus: coded as M50, M55). Professional attitudes and compliance: Measured at the beginning and end of the trial, by questionnaire. |
Patient record, registration form, questionnaire to analyse additional performance and cost-analysis
|
Primary MIM-outcome
| Clinical performance/decision-making: Number of patients (between 17 -35 yr of age) with removed versus retained MIMs in accordance with CPG, or with indication for removal. Number of risk-based assessment radiographs between 17– 35-yrs/per patient with risk-based for assessment of prognosis MIM. |
Patient record, registration form to analyse risk management
|
Secondary MIM-outcome
| Professional attitudes/compliance and feedback: Interviews of patients (17–35 years of age) to confirm risk-based performance. |
Questionnaire
|
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For high-risk children and adolescents (0 to 18 years), recall intervals of less or equal than seven months should be assigned. For those with a low-risk profile, an assigned recall of more than seven months is considered appropriate.
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For high-risk adults (18 years and older): recall intervals of less than nine months should be assigned. For those with a low-risk profile, an interval of nine months or longer is considered appropriate.
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For high caries-risk children and adolescents (0 to 18 years): BW frequencies of less than 24 months are determined as appropriate; for those with a low-caries risk profile, BW frequencies equal or more than 36 months.
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For high caries risk adults (18 years and older): BW frequencies less than 36 months are determined as appropriate; for those with a low-caries risk profile, BW frequencies of equal or more than 48 months.
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The type of recall interval (months) per GDP over the past 3 years
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BW radiographs and other types of radiographs per GDP over the past 3 years
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Type of performer of ROEs: GDP versus oral hygienist/dental auxiliary
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Additional interventions per GDP (i.e. polishing stains/removing dental calculus) encompassed at ROEs over the past 3 years.
MIM study
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Patients (17–35 years of age) with removed versus retained MIMs over the past five years as a proportion of patients aged between 17–35 years of age per practice
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Radiographs used for monitoring patients mentioned above to perform a risk-based assessment and prognosis of MIM over the past five years.