Cost-effectiveness of silicone and alginate impressions for complete dentures
Identifieur interne : 000640 ( Pmc/Curation ); précédent : 000639; suivant : 000641Cost-effectiveness of silicone and alginate impressions for complete dentures
Auteurs : C. Hulme [Royaume-Uni] ; G. Yu [Royaume-Uni] ; C. Browne [Royaume-Uni] ; J. O Wyer [Royaume-Uni] ; H. Craddock [Royaume-Uni] ; S. Brown [Royaume-Uni] ; J. Gray [Royaume-Uni] ; S. Pavitt [Royaume-Uni] ; C. Fernandez [Royaume-Uni] ; M. Godfrey [Royaume-Uni] ; G. Dukanovic [Royaume-Uni] ; P. Brunton [Royaume-Uni, Nouvelle-Zélande] ; T. P. Hyde [Royaume-Uni]Source :
- Journal of Dentistry [ 0300-5712 ] ; 2014.
Abstract
The aim of this study was to assess the cost effectiveness of silicone and alginate impressions for complete dentures.
Cost effectiveness analyses were undertaken alongside a UK single centre, double blind, controlled, crossover clinical trial. Taking the perspective of the healthcare sector, effectiveness is measured using the EuroQol (EQ-5D-3L) which provides a single index value for health status that may be combined with time to produce quality adjusted life years (QALYs); and Oral Health Impact Profile (OHIP-EDENT). Incremental cost effectiveness ratios are presented representing the additional cost per one unit gained.
Mean cost was higher in the silicone impression group (£388.57 vs. £363.18). Negligible between-group differences were observed in QALY gains; the silicone group had greater mean OHIP-EDENT gains. The additional cost using silicone was £3.41 per change of one point in the OHIP-EDENT.
The silicone group was more costly, driven by the cost of materials. Changes in the EQ-5D and QALY gains over time and between arms were not statistically significant. Change in OHIP-EDENT score showed greater improvement in the silicone group and the difference between arms was statistically significant. Given negligible QALY gains and low level of resource use, results must be treated with caution. It is difficult to make robust claims about the comparative cost-effectiveness.
Silicone impressions for complete dentures improve patients’ quality of life (OHIP-EDENT score). The extra cost of silicone impressions is £30 per patient. Dentists, patients and health care funders need to consider the clinical and financial value of silicone impressions. Different patients, different dentists, different health funders will have individual perceptions and judgements.
ISRCTN01528038.
NIHR-RfPB grant PB-PG-0408-16300.
This article forms part of a project for which the author (TPH) won the Senior Clinical Unilever Hatton Award of the International Assocation for Dental Research, Capetown, South Africa, June 2014.
Url:
DOI: 10.1016/j.jdent.2014.03.001
PubMed: 24995472
PubMed Central: 4119300
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Brunton</name><affiliation wicri:level="1"><nlm:aff id="aff0045">Leeds Dental Institute, University of Leeds, Leeds LS2 9LU, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Leeds Dental Institute, University of Leeds, Leeds LS2 9LU</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff0050">Faculty of Dentistry, University of Otago, Dunedin, New Zealand</nlm:aff><country xml:lang="fr">Nouvelle-Zélande</country><wicri:regionArea>Faculty of Dentistry, University of Otago, Dunedin</wicri:regionArea></affiliation></author><author><name sortKey="Hyde, T P" sort="Hyde, T P" uniqKey="Hyde T" first="T. P." last="Hyde">T. P. 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Hulme</name><affiliation wicri:level="1"><nlm:aff id="aff0005">Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds LS2 9LJ, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds LS2 9LJ</wicri:regionArea></affiliation></author><author><name sortKey="Yu, G" sort="Yu, G" uniqKey="Yu G" first="G." last="Yu">G. Yu</name><affiliation wicri:level="1"><nlm:aff id="aff0005">Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds LS2 9LJ, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds LS2 9LJ</wicri:regionArea></affiliation></author><author><name sortKey="Browne, C" sort="Browne, C" uniqKey="Browne C" first="C." last="Browne">C. Browne</name><affiliation wicri:level="1"><nlm:aff id="aff0005">Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds LS2 9LJ, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds LS2 9LJ</wicri:regionArea></affiliation></author><author><name sortKey="O Wyer, J" sort="O Wyer, J" uniqKey="O Wyer J" first="J." last="O Wyer">J. O Wyer</name><affiliation wicri:level="1"><nlm:aff id="aff0005">Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds LS2 9LJ, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds LS2 9LJ</wicri:regionArea></affiliation></author><author><name sortKey="Craddock, H" sort="Craddock, H" uniqKey="Craddock H" first="H." last="Craddock">H. Craddock</name><affiliation wicri:level="1"><nlm:aff id="aff0010">University of Aberdeen Dental School, Cornhill Road, Aberdeen AB25 2ZR, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>University of Aberdeen Dental School, Cornhill Road, Aberdeen AB25 2ZR</wicri:regionArea></affiliation></author><author><name sortKey="Brown, S" sort="Brown, S" uniqKey="Brown S" first="S." last="Brown">S. Brown</name><affiliation wicri:level="1"><nlm:aff id="aff0015">Leeds Institute of Clinical Trials Research, University of Leeds, Leeds LS29JT, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Leeds Institute of Clinical Trials Research, University of Leeds, Leeds LS29JT</wicri:regionArea></affiliation></author><author><name sortKey="Gray, J" sort="Gray, J" uniqKey="Gray J" first="J." last="Gray">J. Gray</name><affiliation wicri:level="1"><nlm:aff id="aff0015">Leeds Institute of Clinical Trials Research, University of Leeds, Leeds LS29JT, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Leeds Institute of Clinical Trials Research, University of Leeds, Leeds LS29JT</wicri:regionArea></affiliation></author><author><name sortKey="Pavitt, S" sort="Pavitt, S" uniqKey="Pavitt S" first="S." last="Pavitt">S. Pavitt</name><affiliation wicri:level="1"><nlm:aff id="aff0025">Leeds Institute of Health Sciences, University of Leeds, Leeds LS2 9LJ, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Leeds Institute of Health Sciences, University of Leeds, Leeds LS2 9LJ</wicri:regionArea></affiliation></author><author><name sortKey="Fernandez, C" sort="Fernandez, C" uniqKey="Fernandez C" first="C." last="Fernandez">C. Fernandez</name><affiliation wicri:level="1"><nlm:aff id="aff0015">Leeds Institute of Clinical Trials Research, University of Leeds, Leeds LS29JT, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Leeds Institute of Clinical Trials Research, University of Leeds, Leeds LS29JT</wicri:regionArea></affiliation></author><author><name sortKey="Godfrey, M" sort="Godfrey, M" uniqKey="Godfrey M" first="M." last="Godfrey">M. Godfrey</name><affiliation wicri:level="1"><nlm:aff id="aff0025">Leeds Institute of Health Sciences, University of Leeds, Leeds LS2 9LJ, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Leeds Institute of Health Sciences, University of Leeds, Leeds LS2 9LJ</wicri:regionArea></affiliation></author><author><name sortKey="Dukanovic, G" sort="Dukanovic, G" uniqKey="Dukanovic G" first="G." last="Dukanovic">G. Dukanovic</name><affiliation wicri:level="1"><nlm:aff id="aff0040">Dental Translational Clinical Research Unit (DenTCRU), Leeds Dental Institute, University of Leeds, Leeds LS2 9LU, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Dental Translational Clinical Research Unit (DenTCRU), Leeds Dental Institute, University of Leeds, Leeds LS2 9LU</wicri:regionArea></affiliation></author><author><name sortKey="Brunton, P" sort="Brunton, P" uniqKey="Brunton P" first="P." last="Brunton">P. Brunton</name><affiliation wicri:level="1"><nlm:aff id="aff0045">Leeds Dental Institute, University of Leeds, Leeds LS2 9LU, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Leeds Dental Institute, University of Leeds, Leeds LS2 9LU</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff0050">Faculty of Dentistry, University of Otago, Dunedin, New Zealand</nlm:aff><country xml:lang="fr">Nouvelle-Zélande</country><wicri:regionArea>Faculty of Dentistry, University of Otago, Dunedin</wicri:regionArea></affiliation></author><author><name sortKey="Hyde, T P" sort="Hyde, T P" uniqKey="Hyde T" first="T. P." last="Hyde">T. P. Hyde</name><affiliation wicri:level="1"><nlm:aff id="aff0045">Leeds Dental Institute, University of Leeds, Leeds LS2 9LU, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Leeds Dental Institute, University of Leeds, Leeds LS2 9LU</wicri:regionArea></affiliation></author></analytic><series><title level="j">Journal of Dentistry</title><idno type="ISSN">0300-5712</idno><idno type="eISSN">1879-176X</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Objective</title><p>The aim of this study was to assess the cost effectiveness of silicone and alginate impressions for complete dentures.</p></sec><sec><title>Methods</title><p>Cost effectiveness analyses were undertaken alongside a UK single centre, double blind, controlled, crossover clinical trial. Taking the perspective of the healthcare sector, effectiveness is measured using the EuroQol (EQ-5D-3L) which provides a single index value for health status that may be combined with time to produce quality adjusted life years (QALYs); and Oral Health Impact Profile (OHIP-EDENT). Incremental cost effectiveness ratios are presented representing the additional cost per one unit gained.</p></sec><sec><title>Results</title><p>Mean cost was higher in the silicone impression group (£388.57 vs. £363.18). Negligible between-group differences were observed in QALY gains; the silicone group had greater mean OHIP-EDENT gains. The additional cost using silicone was £3.41 per change of one point in the OHIP-EDENT.</p></sec><sec><title>Conclusions</title><p>The silicone group was more costly, driven by the cost of materials. Changes in the EQ-5D and QALY gains over time and between arms were not statistically significant. Change in OHIP-EDENT score showed greater improvement in the silicone group and the difference between arms was statistically significant. Given negligible QALY gains and low level of resource use, results must be treated with caution. It is difficult to make robust claims about the comparative cost-effectiveness.</p></sec><sec><title>Clinical significance</title><p>Silicone impressions for complete dentures improve patients’ quality of life (OHIP-EDENT score). The extra cost of silicone impressions is £30 per patient. Dentists, patients and health care funders need to consider the clinical and financial value of silicone impressions. Different patients, different dentists, different health funders will have individual perceptions and judgements.</p><p>ISRCTN01528038.</p><p>NIHR-RfPB grant PB-PG-0408-16300.
</p><p>This article forms part of a project for which the author (TPH) won the Senior Clinical Unilever Hatton Award of the International Assocation for Dental Research, Capetown, South Africa, June 2014.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Fuller, E" uniqKey="Fuller E">E. Fuller</name></author><author><name sortKey="Steele, J" uniqKey="Steele J">J. Steele</name></author><author><name sortKey="Watt, R" uniqKey="Watt R">R. Watt</name></author><author><name sortKey="Nuttall, N" uniqKey="Nuttall N">N. Nuttall</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Petropoulos, V C" uniqKey="Petropoulos V">V.C. Petropoulos</name></author><author><name sortKey="Rashedi, B" uniqKey="Rashedi B">B. Rashedi</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hyde, T P" uniqKey="Hyde T">T.P. 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<front><journal-meta><journal-id journal-id-type="nlm-ta">J Dent</journal-id><journal-id journal-id-type="iso-abbrev">J Dent</journal-id><journal-title-group><journal-title>Journal of Dentistry</journal-title></journal-title-group><issn pub-type="ppub">0300-5712</issn><issn pub-type="epub">1879-176X</issn><publisher><publisher-name>Elsevier</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">24995472</article-id><article-id pub-id-type="pmc">4119300</article-id><article-id pub-id-type="publisher-id">S0300-5712(14)00073-6</article-id><article-id pub-id-type="doi">10.1016/j.jdent.2014.03.001</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Cost-effectiveness of silicone and alginate impressions for complete dentures</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Hulme</surname><given-names>C.</given-names></name><xref rid="aff0005" ref-type="aff">a</xref></contrib><contrib contrib-type="author"><name><surname>Yu</surname><given-names>G.</given-names></name><xref rid="aff0005" ref-type="aff">a</xref></contrib><contrib contrib-type="author"><name><surname>Browne</surname><given-names>C.</given-names></name><xref rid="aff0005" ref-type="aff">a</xref></contrib><contrib contrib-type="author"><name><surname>O’Dwyer</surname><given-names>J.</given-names></name><xref rid="aff0005" ref-type="aff">a</xref></contrib><contrib contrib-type="author"><name><surname>Craddock</surname><given-names>H.</given-names></name><xref rid="aff0010" ref-type="aff">b</xref></contrib><contrib contrib-type="author"><name><surname>Brown</surname><given-names>S.</given-names></name><xref rid="aff0015" ref-type="aff">c</xref></contrib><contrib contrib-type="author"><name><surname>Gray</surname><given-names>J.</given-names></name><xref rid="aff0015" ref-type="aff">c</xref></contrib><contrib contrib-type="author"><name><surname>Pavitt</surname><given-names>S.</given-names></name><xref rid="aff0025" ref-type="aff">d</xref></contrib><contrib contrib-type="author"><name><surname>Fernandez</surname><given-names>C.</given-names></name><xref rid="aff0015" ref-type="aff">c</xref></contrib><contrib contrib-type="author"><name><surname>Godfrey</surname><given-names>M.</given-names></name><xref rid="aff0025" ref-type="aff">d</xref></contrib><contrib contrib-type="author"><name><surname>Dukanovic</surname><given-names>G.</given-names></name><xref rid="aff0040" ref-type="aff">e</xref></contrib><contrib contrib-type="author"><name><surname>Brunton</surname><given-names>P.</given-names></name><xref rid="aff0045" ref-type="aff">f</xref><xref rid="aff0050" ref-type="aff">g</xref></contrib><contrib contrib-type="author"><name><surname>Hyde</surname><given-names>T.P.</given-names></name><email>t.p.hyde@leeds.ac.uk</email><xref rid="aff0045" ref-type="aff">f</xref><xref rid="cor0005" ref-type="corresp">⁎</xref></contrib></contrib-group><aff id="aff0005"><label>a</label>Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds LS2 9LJ, UK</aff><aff id="aff0010"><label>b</label>University of Aberdeen Dental School, Cornhill Road, Aberdeen AB25 2ZR, UK</aff><aff id="aff0015"><label>c</label>Leeds Institute of Clinical Trials Research, University of Leeds, Leeds LS29JT, UK</aff><aff id="aff0025"><label>d</label>Leeds Institute of Health Sciences, University of Leeds, Leeds LS2 9LJ, UK</aff><aff id="aff0040"><label>e</label>Dental Translational Clinical Research Unit (DenTCRU), Leeds Dental Institute, University of Leeds, Leeds LS2 9LU, UK</aff><aff id="aff0045"><label>f</label>Leeds Dental Institute, University of Leeds, Leeds LS2 9LU, UK</aff><aff id="aff0050"><label>g</label>Faculty of Dentistry, University of Otago, Dunedin, New Zealand</aff><author-notes><corresp id="cor0005"><label>⁎</label><italic>Corresponding author</italic>. Tel.: +44 0113 343 8515. <email>t.p.hyde@leeds.ac.uk</email></corresp></author-notes><pub-date pub-type="pmc-release"><day>1</day><month>8</month><year>2014</year></pub-date><pmc-comment> PMC Release delay is 0 months and 0 days and was based on .</pmc-comment>
<pub-date pub-type="ppub"><month>8</month><year>2014</year></pub-date><volume>42</volume><issue>8</issue><fpage>902</fpage><lpage>907</lpage><history><date date-type="received"><day>7</day><month>10</month><year>2013</year></date><date date-type="rev-recd"><day>5</day><month>2</month><year>2014</year></date><date date-type="accepted"><day>1</day><month>3</month><year>2014</year></date></history><permissions><copyright-statement>© 2014 The Authors</copyright-statement><copyright-year>2014</copyright-year><license license-type="CC BY-NC-SA" xlink:href="http://creativecommons.org/licenses/by-nc-sa/3.0/"><license-p>This is an open access article under the CC BY-NC-SA license (http://creativecommons.org/licenses/by-nc-sa/3.0/).</license-p></license></permissions><abstract><sec><title>Objective</title><p>The aim of this study was to assess the cost effectiveness of silicone and alginate impressions for complete dentures.</p></sec><sec><title>Methods</title><p>Cost effectiveness analyses were undertaken alongside a UK single centre, double blind, controlled, crossover clinical trial. Taking the perspective of the healthcare sector, effectiveness is measured using the EuroQol (EQ-5D-3L) which provides a single index value for health status that may be combined with time to produce quality adjusted life years (QALYs); and Oral Health Impact Profile (OHIP-EDENT). Incremental cost effectiveness ratios are presented representing the additional cost per one unit gained.</p></sec><sec><title>Results</title><p>Mean cost was higher in the silicone impression group (£388.57 vs. £363.18). Negligible between-group differences were observed in QALY gains; the silicone group had greater mean OHIP-EDENT gains. The additional cost using silicone was £3.41 per change of one point in the OHIP-EDENT.</p></sec><sec><title>Conclusions</title><p>The silicone group was more costly, driven by the cost of materials. Changes in the EQ-5D and QALY gains over time and between arms were not statistically significant. Change in OHIP-EDENT score showed greater improvement in the silicone group and the difference between arms was statistically significant. Given negligible QALY gains and low level of resource use, results must be treated with caution. It is difficult to make robust claims about the comparative cost-effectiveness.</p></sec><sec><title>Clinical significance</title><p>Silicone impressions for complete dentures improve patients’ quality of life (OHIP-EDENT score). The extra cost of silicone impressions is £30 per patient. Dentists, patients and health care funders need to consider the clinical and financial value of silicone impressions. Different patients, different dentists, different health funders will have individual perceptions and judgements.</p><p>ISRCTN01528038.</p><p>NIHR-RfPB grant PB-PG-0408-16300.
</p><p>This article forms part of a project for which the author (TPH) won the Senior Clinical Unilever Hatton Award of the International Assocation for Dental Research, Capetown, South Africa, June 2014.</p></sec></abstract><kwd-group><title>Keywords</title><kwd>Prosthodontics</kwd><kwd>Quality-of life</kwd><kwd>Impression materials</kwd><kwd>Cost effectiveness</kwd><kwd>Cost</kwd><kwd>Resource</kwd></kwd-group></article-meta></front><floats-group><table-wrap id="tbl0005" position="float"><label>Table 1</label><caption><p>Unit costs.</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left">Services</th><th align="center">Unit cost</th><th align="center">Source</th><th align="center">Note</th></tr></thead><tbody><tr><td align="left">GP, surgery visit (face to face)</td><td align="char">£43.29</td><td align="left">(Curtis, 2012)<xref rid="bib0105" ref-type="bibr"><sup>21</sup></xref> – p183 – with qualification per minute (£3.70). Including direct care staff costs</td><td align="left">Average visit time is 11.7 min (PSSRU p. 182) (£3.70 × 11.7)</td></tr><tr><td align="left">GP, surgery visit (tel/email)</td><td align="char">£26.27</td><td align="left">(Curtis, 2012)<xref rid="bib0105" ref-type="bibr"><sup>21</sup></xref> – p183 – with qualification – lasting 7.1 min</td><td></td></tr><tr><td align="left">GP, home visit</td><td align="char">£110.00</td><td align="left">(Curtis, 2012)<xref rid="bib0105" ref-type="bibr"><sup>21</sup></xref> – p183 – with qualification – per visit (Inc. travel time)</td><td align="left">Per out of surgery visit lasting 23.4 min</td></tr><tr><td align="left">District nurse, home visiting</td><td align="char">£27.30</td><td align="left">(Curtis, 2012)<xref rid="bib0105" ref-type="bibr"><sup>21</sup></xref> – p175/183 – with qualification – per visit (Inc. travel)</td><td align="left">£70 per hour. Assume visit time is same as GP out of surgery, i.e. 23.4 min (70/60*23.4)</td></tr><tr><td align="left">District nurse, patient-related work</td><td align="char">£6.86</td><td align="left">(Curtis, 2012)<xref rid="bib0105" ref-type="bibr"><sup>21</sup></xref> – p175 – with qualification – per contact</td><td align="left">Assume contact is telephone call and is same length as GP = 7.1 min (58/60*7.1)</td></tr><tr><td align="left">Hospital inpatient stay</td><td align="char">£586.00</td><td align="left">(Curtis, 2012)<xref rid="bib0105" ref-type="bibr"><sup>21</sup></xref> – p109. Non-elective inpatient stays (short stays)</td><td></td></tr><tr><td align="left">Hospital A&E – leading to admitted</td><td align="char">£152.00</td><td align="left">(Lloyd-Jones et al., 2009)<xref rid="bib0110" ref-type="bibr"><sup>22</sup></xref> – dental care – HRG code: VB10Z</td><td></td></tr><tr><td align="left">Hospital A&E – not leading to admitted</td><td align="char">£68.00</td><td align="left">(Lloyd-Jones et al., 2009) [22] – dental care – HRG code: VB10Z</td><td></td></tr><tr><td align="left">Hospital general outpatient clinic – dental medicine specialities</td><td align="char">£105.00</td><td align="left">(Lloyd-Jones et al., 2009)<xref rid="bib0110" ref-type="bibr"><sup>22</sup></xref> – outpatient attendances – service code: 450</td><td></td></tr><tr><td align="left">Lab cost: full upper or lower only with standard teeth (2× for F/F)</td><td align="char">£167.05</td><td align="left">Mgill website (<ext-link ext-link-type="uri" xlink:href="http://www.mgill.co.uk/Price_list/index.html" id="intr0005">http://www.mgill.co.uk/Price_list/index.html</ext-link>), November 2012</td><td></td></tr></tbody></table><table frame="hsides" rules="groups"><thead><tr><th align="left">Salary</th><th align="center">Per hour</th><th align="center">Year</th><th align="center">2012 (adjusted for inflation) (CCEMG – EPPI-centre cost converter, 2013)</th><th align="center">Source</th></tr></thead><tbody><tr><td align="left">Dentist (NHS, England)</td><td align="char">£32.87</td><td align="char">2011</td><td align="char">£33.69</td><td align="left">Pay circular (M&D) 1/2011 and PSSRU p. 182</td></tr></tbody></table><table frame="hsides" rules="groups"><thead><tr><th colspan="3" align="center">Overheads<hr></hr></th></tr><tr><th></th><th align="center">% of income</th><th align="center">Dentist (NHS, England) as above</th></tr></thead><tbody><tr><td align="left">Wages and NI (per hour)</td><td align="char">17.42%</td><td align="char">£33.69</td></tr><tr><td align="left">Overheads (per hour)</td><td align="char">12.77%</td><td align="char">£24.70</td></tr></tbody></table><table frame="hsides" rules="groups"><thead><tr><th align="center">Cost of materials</th><th align="center">Per bag/box</th><th align="center">Per patient</th><th align="center">Item</th></tr></thead><tbody><tr><td align="char">1</td><td align="char">£10.99</td><td align="char">£0.79</td><td align="left">Heraeus/Kulzer Xantalgin select refill bag 500 g (10.99/14)</td></tr><tr><td align="char">2</td><td align="char">£16.89</td><td align="char">£2.41</td><td align="left">Impression compound stick Kerr Greenper box (16.89/7)</td></tr><tr><td align="char">3</td><td align="char">£24.59</td><td align="char">£1.64</td><td align="left">GC Europe iso functional stick Pink 120 g box (24.59/15)</td></tr><tr><td align="char">4</td><td align="char">£77.29</td><td align="char">£7.73</td><td align="left">3 M Espe Express 2 regular body Quick set 4 × 50 ml (77.29/10)</td></tr><tr><td align="char">5</td><td align="char">£45.99</td><td align="char">£6.57</td><td align="left">Kerr Extrude Purple 2 × 50 ml & tips (45.99/7)</td></tr><tr><td align="char">6</td><td align="char">£77.29</td><td align="char">£19.32</td><td align="left">3 M Espe Express 2 light body standard Quick set 4 × 50 ml (77.29/4)</td></tr></tbody></table><table frame="hsides" rules="groups"><thead><tr><th align="left">Total</th><th align="center">Per patient</th><th align="center">Notes</th></tr></thead><tbody><tr><td align="left">Alginate (1,2,3)</td><td align="char">£4.84</td><td align="left">(Green stick and pink stick impressions cost (2.41 + 1.64 + 0.79)</td></tr><tr><td align="left">Silicone (3,4,5,6)</td><td align="char">£35.26</td><td align="left">(Heavy medium and light) and pink stick impression cost (1.64 + 6.57 + 19.32 + 7.73)</td></tr></tbody></table></table-wrap><table-wrap id="tbl0010" position="float"><label>Table 2</label><caption><p>Procedures and costs.</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left">Resource</th><th colspan="2" align="center">Silicone<hr></hr></th><th colspan="2" align="center">Alginate<hr></hr></th></tr><tr><th></th><th align="center">Time (min)</th><th align="center">Cost (£)</th><th align="center">Time (min)</th><th align="center">Cost (£)</th></tr><tr><th></th><th align="center">Mean (SD)</th><th align="center">Mean (SD)</th><th align="center">Mean (SD)</th><th align="center">Mean (SD)</th></tr></thead><tbody><tr><td colspan="5" align="left"><bold>Baseline</bold></td></tr><tr><td align="left">Primary impression</td><td align="left">5.74 (2.42)</td><td align="left">5.75 (2.33)</td><td align="left">5.74 (2.42)</td><td align="left">5.75 (2.33)</td></tr><tr><td align="left">Secondary impression</td><td align="left">17.05 (3.64)</td><td align="left">16.59 (3.54)</td><td align="left">16.63 (4.29)</td><td align="left">16.19 (4.18)</td></tr><tr><td align="left">Jaw registration</td><td align="left">12.84 (5.13)</td><td align="left">12.49 (4.99)</td><td align="left">12.84 (5.13)</td><td align="left">12.49 (4.99)</td></tr><tr><td align="left">Try in</td><td align="left">7.52 (5.60)</td><td align="left">7.32 (5.45)</td><td align="left">7.52 (5.60)</td><td align="left">7.32 (5.45)</td></tr><tr><td align="left">Fit</td><td align="left">8.27 (6.14)</td><td align="left">8.05 (5.98)</td><td align="left">8.27 (6.14)</td><td align="left">8.05 (5.98)</td></tr><tr><td align="left">Other</td><td align="left">8.58 (6.16)</td><td align="left">8.35 (5.99)</td><td align="left">8.58 (6.16)</td><td align="left">8.35 (5.99)</td></tr><tr><td colspan="5" align="left"><bold>Adjustment periods</bold></td></tr><tr><td align="left">Trimming and polishing</td><td align="left">7.88 (5.44)</td><td align="left">7.68 (5.30)</td><td align="left">7.77 (6.49)</td><td align="left">7.56 (6.31)</td></tr><tr><td align="left">Rebase/reline (1st appointment)</td><td align="left">0.29 (1.74)</td><td align="left">0.29 (1.69)</td><td align="left">0.00</td><td align="left">0.00</td></tr><tr><td align="left">Rebase/reline (2nd appointment)</td><td align="left">0.01 (0.04)</td><td align="left">0.01 (0.04)</td><td align="left">0.59 (4.51)</td><td align="left">0.58 (4.39)</td></tr><tr><td align="left">Chairside adjustment of occlusal errors</td><td align="left">0.15 (0.72)</td><td align="left">0.14 (0.70)</td><td align="left">0.28 (1.29)</td><td align="left">0.27 (1.26)</td></tr><tr><td align="left">Check record (adjustment of occlusal errors)</td><td align="left">0.00</td><td align="left">0.00</td><td align="left">0.00</td><td align="left">0.00</td></tr><tr><td align="left">Lab based occlusal adjustment</td><td align="left">0.00</td><td align="left">0.00</td><td align="left">0.00</td><td align="left">0.00</td></tr><tr><td align="left">Other</td><td align="left">0.83 (2.80)</td><td align="left">0.81 (2.73)</td><td align="left">0.19 (0.45)</td><td align="left">0.18 (0.44)</td></tr><tr><td align="left">Subtotal</td><td align="left">8.97 (5.13)</td><td align="left">8.73 (4.99)</td><td align="left">8.75 (7.16)</td><td align="left">8.52 (6.97)</td></tr><tr><td align="left">Material</td><td align="left">N/A</td><td align="left">35.26</td><td align="left">N/A</td><td align="left">4.84</td></tr><tr><td align="left">Total</td><td></td><td align="left">44.09</td><td></td><td align="left">13.36</td></tr><tr><td align="left">(SD)</td><td></td><td align="left">(4.99)</td><td></td><td align="left">(6.97)</td></tr><tr><td align="left"><italic>N</italic></td><td></td><td align="left">71</td><td></td><td align="left">71</td></tr></tbody></table></table-wrap><table-wrap id="tbl0015" position="float"><label>Table 3</label><caption><p>EQ-5D and OHIP-EDENT scores.</p></caption><table frame="hsides" rules="groups"><thead><tr><th colspan="4" align="center">EQ-5D<hr></hr></th></tr><tr><th></th><th></th><th align="center">Silicone</th><th align="center">Alginate</th></tr></thead><tbody><tr><td align="left">Baseline</td><td align="left">Mean (SD)</td><td align="char">0.73 (0.27)</td><td align="char">0.73 (0.27)</td></tr><tr><td></td><td align="left"><italic>N</italic></td><td align="char">71</td><td align="char">71</td></tr><tr><td align="left">Follow-up</td><td align="left">Mean (SD)</td><td align="char">0.71 (0.34)</td><td align="char">0.77 (0.26)</td></tr><tr><td align="left">Change</td><td align="left">Mean (SD)</td><td align="char">−0.02 (0.23)</td><td align="char">0.04 (0.20)</td></tr></tbody></table><table frame="hsides" rules="groups"><thead><tr><th colspan="4" align="center">OHIP-EDENT<hr></hr></th></tr><tr><th align="left">Time point</th><th></th><th align="center">Silicone</th><th align="center">Alginate</th></tr></thead><tbody><tr><td align="left">Baseline</td><td align="left">Mean (SD)</td><td align="char">44.20 (17.61)</td><td align="char">44.07 (17.52)</td></tr><tr><td></td><td align="left"><italic>N</italic></td><td align="char">70<xref rid="tblfn0005" ref-type="table-fn">a</xref></td><td align="char">71</td></tr><tr><td align="left">Follow-up</td><td align="left">Mean (SD)</td><td align="char">28.64 (18.92)</td><td align="char">36.17 (19.58)</td></tr><tr><td align="left">Change</td><td align="left">Mean (SD)</td><td align="char">−15.56 (20.51)</td><td align="char">−7.90 (22.69)</td></tr></tbody></table><table-wrap-foot><fn id="tblfn0005"><label>a</label><p>One patient with missing values of >50% items was excluded.</p></fn></table-wrap-foot></table-wrap><table-wrap id="tbl0020" position="float"><label>Table 4</label><caption><p>Between-group comparisons of cost-effectiveness.</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left">Treatment</th><th colspan="3" align="center">Costs (£)<hr></hr></th><th colspan="3" align="center">QALY<hr></hr></th><th align="center">Cost/effectiveness ratio (£/QALY)</th></tr><tr><th></th><th align="center">Mean</th><th align="center">SD</th><th align="center">Between-treatment increment</th><th align="center">Mean</th><th align="center">SD</th><th align="center">Between-treatment increment</th><th></th></tr></thead><tbody><tr><td colspan="8" align="left"><bold>Overall</bold></td></tr><tr><td align="left">Alginate (<italic>N</italic> = 71)</td><td align="char">363</td><td align="char">43</td><td align="char">26</td><td align="char">0.06</td><td align="char">0.02</td><td align="char">−0.004</td><td align="char">−5.758 (alginate dominates)</td></tr><tr><td align="left">Silicone (<italic>N</italic> = 71)</td><td align="char">389</td><td align="char">16</td><td></td><td align="char">0.05</td><td align="char">0.02</td><td></td><td></td></tr></tbody></table><table frame="hsides" rules="groups"><thead><tr><th align="left">Treatment</th><th colspan="3" align="center">Costs (£)<hr></hr></th><th colspan="3" align="center">OHIP points<hr></hr></th><th align="center">Cost/effectiveness ratio (£/OHIP)</th></tr><tr><th></th><th align="center">Mean</th><th align="center">SD</th><th align="center">Between-treatment increment</th><th align="center">Mean</th><th align="center">SD</th><th align="center">Between-treatment increment</th><th></th></tr></thead><tbody><tr><td colspan="8" align="left"><bold>Overall</bold></td></tr><tr><td align="left">Alginate (<italic>N</italic> = 71)</td><td align="char">363</td><td align="char">43</td><td align="char">26</td><td align="char">36.17</td><td align="char">19.58</td><td align="char">7.53</td><td align="char">3.41</td></tr><tr><td align="left">Silicone (<italic>N</italic> = 70)</td><td align="char">389</td><td align="char">18</td><td></td><td align="char">28.64</td><td align="char">18.92</td><td></td><td></td></tr></tbody></table></table-wrap></floats-group></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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