Choose an application

• Reference Manager
• EndNote
• RefWorks (Direct export to RefWorks)

1. General introduction; 2. Current evidence on orthodontic treatment: a survey of the clinical literature; 3. Orthodontics organization and financing: overview of 8 countries based on literature and international questionnaire; 4. Belgian situation: organisation, regulation and density of practitioners; 5. Belgian situation: estimates on fees, reimbursement and out-of-pocket payments for orthodontic treatment; 6. Belgian situation: RIZIV/INAMI expenditures; 7. Belgian situation: orthodontic practices; 8. Belgian situation: some epidemiological estimates; 9. Belgian situation: cost analysis and budget impact calculations; 10. References

Choose an application

• Reference Manager
• EndNote
• RefWorks (Direct export to RefWorks)

Choose an application

• Reference Manager
• EndNote
• RefWorks (Direct export to RefWorks)

This article describes the preliminary development of the ‘Orthodontic Care Index’ (OCI), an evidence-based scoring system that aims to objectify orthodontic treatment need (OTN), - complexity (OTC) and - priority (OTP) by including patient- and treatment-related factors influencing these three components. The development of the OCI involved eight phases. First, all parameters that may play a role in determining the need, complexity or urgency of orthodontic treatment were identified based on a systematic review of the literature. Second, to create a logical outline, the parameters were attributed to different overhead domains and further subdivided into subgroup parameters. Third, in order to quantify the parameters and subgroup parameters, an eight-member panel of orthodontic specialists was consulted to determine the level of impact that each parameter had on the decision-making process to determine OTN, OTC or OTP. Parameters considered of no – or little influence were subsequently eliminated. Fourth, a retrospective ‘convenience sample’ consisting of pre-treatment records of 61 patients, was collected from the database of University Hospitals Leuven. The parameters influencing OTN, OTC and OTP that occurred in this sample were scored by the two main authors by using the generated parameter scoring-list. Fifth, a third expert panel gave an overall score for OTN, OTC and OTP to each patient of the same convenience sample. Sixth, linear regression analysis was performed to estimate the weights of each overhead domain and to construct a formula to calculate a score for OTN, OTC and OTP separately. Seventh, to determine a golden standard, the OTN, OTC and OTP ‘as perceived’ by the orthodontic specialists was obtained by calculating the mean score of the third panel. Lastly, the index performance was quantified by calculating its variability (R-square), sensitivity and specificity. With this preliminary index, the OTN, OTC and OTP can be calculated for a patient as the weighted sum of his/her domain scores. While the variability of OTN, OTC and OTP was relatively low (52.1%, 31.2%, and 52.6% respectively), the sensitivity of the whole index for predicting treatment need, - complexity and - priority was high (98.1%, 82.9% and 92.7% respectively). This suggests that the index is potentially useful for distinguishing a case’s treatment need, complexity and priority. Further refinement and validation of the index is needed to enhance its performance and usefulness.