69名正畸专家对正畸疗效满意度主观评价的研究

Research on Chinese orthodontic specialists＇ subjective evaluation of orthodontic treatment outcome

目的 分析多名正畸专家对正畸治疗后各种临床资料主观评判结果,深入探讨各种单一资料的相关性及其在组合评价中所占比重,以期为正畸疗效客观评价指标的建立提供参考.方法 以院校和安氏分类作为随机抽样的分层因素,利用计算机产生的伪随机数表,从全国6个口腔医学院校正畸科近5年完成的2383例病例中,随机抽取108例作为样本.将样本治疗后模型、头颅侧位X线片和面像作为研究资料,以安氏分类作为随机分组的分层因素,采用计算机产生的伪随机数表将108例病例随机等分为9组.从全国各地邀请正畸专家69名,依据治疗后的各项临床资料或多项资料组合,对每组12例病例的疗效满意度进行排序,并对疗效进行满意和合格判断.结果 相关性方面：模型＋头颅侧位X线片（M＋C）和模型＋面像（M＋P）的结果与模型＋头颅侧位X线片＋面像（M＋C＋P）结果的相关系数＞0.950.单独评价M与单独评价P、C的相关系数均为0.300左右；单独评价P和单独评价C的相关系数为0.505.权重方面：建立单一资料与组合资料评判结果的回归模型如下：M ＋C =0.782M ＋0.308C -0.150,M＋P =0.804M ＋0.233P-0.091,M＋C ＋P=0.764M＋0.243P ＋0.131C-0.291.3个模型的r2均＞0.9.结论 进行正畸疗效评价时,纳入头颅侧位X线片和面像是必要的,采用结合各种单一资料的评判手段能有效地反映组合资料的评判结果,模型与头颅侧位X线片或模型与面像的组合均可全面反映3种资料组合判断的结果.

Objective To analyze the results of multiple Chinese orthodontic specialists＇ subjective evaluation of orthodontic treatment outcome,to investigate the relevance of different experiment items and to explore the weight of each monomial material.Methods As a randomized clinical trial,with six orthodontic treatment centers and Angle＇s classification being regarded as two stratification factors,it contained 108 cases with integrity data,which was random extracted from 2383 cases that received orthodontic treatment in six orthodontic treatment centers during the past five years, gathering post-treatment study casts,cephalometrics and photographs of 48 cases as the research subject.Similarly taking Angle＇s classification as a stratification factor,108 cases were randomly divided into 9 groups.The randomization of sampling and grouping were both generated by a pseudo-random number generator. According to the monomial and combined subjects,69 orthodontic specialists were regarded as the raters to rank the 12 cases in each group,and to judge whether the case was qualified. Results Correlation analysis：the Spearman r between Post-M ＋ C and Post-M ＋ C ＋ P and the Spearman r between Post-M ＋ P and Post-M ＋ C ＋ P were both greater than 0.950.The Spearman r between Post-M and Post-P and the Spearman r between Post-M and Post-C were about 0.300.The Spearman r between Post-P and Post-C was 0.505.Regression analysis：the linear regression results：M ＋ C =0.782M ＋0.308C -0.150,M ＋ P =0.804M ＋0.233P -0.091,M ＋ C ＋P =0.764M ＋0.243P ＋0.131C -0.291.The r2 of above three models was greater than 0.9.Conclusions It was applicable to use M ＋ C and M ＋ P instead of M ＋ C ＋ P.Study casts could not replace cephalometrics or photographs when doing subjective evaluation. Cephalometrics and photographs could not substitute for each other either.In the combined materials evaluation,model accounted for the largest percentage.Based on the regression model,for the greater part,the integration of several monomial materials could replace the combined material assessment effectively.