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

doi:10.1111/idj.12604

. 2021 Feb;71(1):40-52.

doi: 10.1111/idj.12604. Epub 2021 Jan 16.

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

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: richeal.niriordain@gmail.com.
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.

PMID: 33616051
PMCID: PMC9275363
DOI: 10.1111/idj.12604

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

Richeal Ni Riordain et al. Int Dent J. 2021 Feb.

. 2021 Feb;71(1):40-52.

doi: 10.1111/idj.12604. Epub 2021 Jan 16.

Authors

Affiliations

¹ ICHOM Adult Oral Health Working Group, Boston, MA, USA; University College London, London, UK; University College Cork, Cork, Ireland. Electronic address: richeal.niriordain@gmail.com.
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.

PMID: 33616051
PMCID: PMC9275363
DOI: 10.1111/idj.12604

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.

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Conflict of interest statement

Conflict of interest The authors declare no potential conflicts of interest with respect to the authorship and/or publication of this article.

Figures

**Fig 2**
Patient advisory group demographics.

**Fig 3**
Delphi process in the development of Adult Oral Health Standard Set (AOHSS).

**Fig 5**
Adult Oral Health Standard Set (AOHSS).

**Fig 6**
Mapping of Adult Oral Health Standard Set (AOHSS) to FDI oral health framework.

See this image and copyright information in PMC

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References

1. Watt R, Sheiham A. Integrating the common risk factor approach into social determinants framework. Commun Dent Oral Epidemiol. 2012;40:289–296. - PubMed
1. Locker D, Allen F. What do measures of ’oral health-related quality of life’ measure? Community Dent Oral Epidemiol. 2007;35:401–411. - PubMed
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[1] Watt R, Sheiham A. Integrating the common risk factor approach into social determinants framework. Commun Dent Oral Epidemiol. 2012;40:289–296. - PubMed

[2] Watt R, Sheiham A. Integrating the common risk factor approach into social determinants framework. Commun Dent Oral Epidemiol. 2012;40:289–296. - PubMed

[3] Locker D, Allen F. What do measures of ’oral health-related quality of life’ measure? Community Dent Oral Epidemiol. 2007;35:401–411. - PubMed

[4] Locker D, Allen F. What do measures of ’oral health-related quality of life’ measure? Community Dent Oral Epidemiol. 2007;35:401–411. - PubMed

[5] Allen PF. Assessment of oral health related quality of life. Health Qual Life Outcomes. 2003;1:40. - PMC - PubMed

[6] Allen PF. Assessment of oral health related quality of life. Health Qual Life Outcomes. 2003;1:40. - PMC - PubMed

[7] Delaney LJ. Patient-centred care as an approach to improving health care in Australia. Collegian. 2018;25:119–123.

[8] Delaney LJ. Patient-centred care as an approach to improving health care in Australia. Collegian. 2018;25:119–123.

[9] Petersen PE. The World Oral Health Report 2003: continuous improvement of oral health in the 21st century–the approach of the WHO Global Oral Health Programme. Community Dent Oral Epidemiol. 2003;31(Suppl 1):3–23. - PubMed

[10] Petersen PE. The World Oral Health Report 2003: continuous improvement of oral health in the 21st century–the approach of the WHO Global Oral Health Programme. Community Dent Oral Epidemiol. 2003;31(Suppl 1):3–23. - PubMed

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

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

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