Development and Content Validity of the International Association for Disability and Oral Health Universal Case Mix Tool: A Consensus Study

IF 2.1 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Community dentistry and oral epidemiology Pub Date : 2025-04-30 DOI:10.1111/cdoe.13041

Caoimhin Mac Giolla Phadraig, Denise Faulks, Colman McGrath, Alison Dougall, Gustavo Molina

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引用次数: 0

Abstract

Objectives

To develop the International Association for Disability and Oral Health Universal Case Mix Tool (iADH UCMT) that rates case complexity in the delivery of oral healthcare.

Methods

A modified e-Delphi survey sought consensus on the content of a universal Case Mix Tool to rate the degree of adaptation over and above that required for the general population, with respect to time, resources and/or expertise necessary to provide high-quality care and equitable outcomes. The survey consisted of candidate domains, ratings and descriptors, following a scoping review of the literature. The consensus threshold was set a priori at ≥ 75% agreement. Expert agreement was sought on both content and wording, and free text comments were subsequently used to refine the exact wording of each domain and descriptor. A consensus meeting followed to rate descriptors for cultural acceptability and clarity, using 5-point Likert scales. Terms were aligned linguistically to ensure consistency across domains, scores and descriptors, and a glossary of definitions was refined.

Results

From the 70 registrants, 40 completed the survey (participation rate 59.7%). Respondents demonstrated a high level of agreement regarding the appropriateness of the seven domains, with agreement ranging from 90% to 100%. Consensus for rating descriptors was also high (85%–95%). Twenty-seven panellists and five development team members attended the consensus meeting, where cultural acceptability (means ranged from 4.6 to 4.8) and clarity (means ranged from 4.2 to 4.7) were demonstrated across domains. This consensus process produced an iADH Universal Case Mix Tool consisting of seven domains: Communication; Dental behaviour support; Medical status; Risk factors for oral disease and dysfunction; Autonomy; Legal and ethical barriers; and, Access to adapted care at the services, systems and policies level. Each Domain has four possible ratings to reflect the degree of adaptation required with respect to time, resources and/or expertise necessary to provide high-quality care and equitable outcomes. The domains, ratings and descriptors were found to be appropriate, clear and culturally acceptable.

Conclusions

An international panel developed a Universal Case Mix Tool to rate complexity in the delivery of oral health care. Acceptable content validity was confirmed, and further psychometric testing is planned.

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国际残疾和口腔健康协会通用病例混合工具的发展和内容有效性：一项共识研究。

目的：开发国际残疾和口腔健康协会通用病例组合工具（iADH UCMT），评估口腔保健交付中的病例复杂性。方法：一项修改后的e-Delphi调查寻求对通用病例组合工具的内容达成共识，以评估在提供高质量护理和公平结果所需的时间、资源和/或专业知识方面超过普通人群所需的适应程度。该调查包括候选领域、评级和描述符，随后对文献进行了范围审查。共识阈值被先验地设定为≥75%的一致性。在内容和措辞上寻求专家的一致意见，随后使用自由文本注释来改进每个领域和描述符的确切措辞。随后召开了一次共识会议，使用李克特5分量表对描述符的文化可接受性和清晰度进行评分。术语在语言上进行了对齐，以确保跨领域、分数和描述符的一致性，并改进了定义术语表。结果：在70名登记者中，有40人完成调查，参与率为59.7%。受访者对这七个领域的适当性表现出高度的一致性，一致性从90%到100%不等。评级描述符的一致性也很高（85%-95%）。27名小组成员和5名开发团队成员参加了共识会议，其中跨领域展示了文化可接受性（平均值从4.6到4.8）和清晰度（平均值从4.2到4.7）。这一共识过程产生了一个由七个领域组成的iADH通用案例组合工具：通信；牙科行为支持；医疗状况;口腔疾病和功能障碍的危险因素；自治;法律和道德障碍；在服务、系统和政策层面获得适应的医疗服务。每个领域有四个可能的评级，以反映在提供高质量护理和公平结果所需的时间、资源和/或专业知识方面所需的适应程度。这些领域、评级和描述符被认为是适当的、清晰的和文化上可接受的。结论：一个国际小组开发了一个通用病例组合工具来评估口腔卫生保健提供的复杂性。确认了可接受的内容效度，并计划进行进一步的心理测试。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Community dentistry and oral epidemiology 医学-公共卫生、环境卫生与职业卫生

CiteScore

4.40

自引率

8.70%

发文量

审稿时长

6 months

期刊介绍： The aim of Community Dentistry and Oral Epidemiology is to serve as a forum for scientifically based information in community dentistry, with the intention of continually expanding the knowledge base in the field. The scope is therefore broad, ranging from original studies in epidemiology, behavioral sciences related to dentistry, and health services research through to methodological reports in program planning, implementation and evaluation. Reports dealing with people of all age groups are welcome. The journal encourages manuscripts which present methodologically detailed scientific research findings from original data collection or analysis of existing databases. Preference is given to new findings. Confirmations of previous findings can be of value, but the journal seeks to avoid needless repetition. It also encourages thoughtful, provocative commentaries on subjects ranging from research methods to public policies. Purely descriptive reports are not encouraged, nor are behavioral science reports with only marginal application to dentistry. The journal is published bimonthly.