Evidence map›Paper›PMID 30823894›Full record

ArticleBMC oral health2019

Unintended consequences and challenges of quality measurements in dentistry.

Enihomo M Obadan-Udoh, Jean M Calvo, Sapna Panwar, Kristen Simmons, Joel M White, Muhammad F Walji, Elsbeth Kalenderian

Abstract read
In one paragraph

Article in BMC oral health, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Article
  2. Observational
  3. Article
  4. Article
  5. Article
  6. Measuring sealant placement in children at the dental practice level.Journal of the American Dental Association (1939) · 2020
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Enihomo M Obadan-UdohDepartment of Preventive and Restorative Dental Sciences, School of Dentistry, University of California San Francisco, 707 Parnassus Avenue, San Francisco, CA, 94143, USA. Enihomo.obadan-udoh@ucsf.edu.ORCID 0000-0002-1005-7241
Jean M CalvoPediatric Dentistry Post-Graduate Program, School of Dentistry, University of California San Francisco, 707 Parnassus Ave, San Francisco, CA, 94143, USA.
Sapna PanwarDepartment of Preventive and Restorative Dental Sciences, School of Dentistry, University of California San Francisco, 707 Parnassus Avenue, San Francisco, CA, 94143, USA.
Kristen SimmonsSkourtes Institute, 6950 NE Campus Way, Hillsboro, OR, 97124, USA.
Joel M WhiteDepartment of Preventive and Restorative Dental Sciences, School of Dentistry, University of California San Francisco, 707 Parnassus Avenue, San Francisco, CA, 94143, USA.
Muhammad F WaljiDepartment of Diagnostic and Biomedical Sciences, School of Dentistry, University of Texas Health Science Center, 7500 Cambridge St., Houston, 77054, TX, USA.
Elsbeth KalenderianDepartment of Preventive and Restorative Dental Sciences, School of Dentistry, University of California San Francisco, 707 Parnassus Avenue, San Francisco, CA, 94143, USA.

Funding

Implementing Dental Quality Measures in PracticeR01DE024166 · NIDCR · UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON · PI KALENDERIAN, ELSBETH, WALJI, MUHAMMAD · 2015 to 2025
$7.3M
NIDCR NIH HHS R01 DE024166
6 · The paper itself

Abstract

backgroundIn recent years, several state dental programs, researchers and the Dental Quality Alliance (DQA) have sought to develop baseline quality measures for dentistry as a way to improve health outcomes, reduce costs and enhance patient experiences. Some of these measures have been tested and validated for various population groups. However, there are some unintended consequences and challenges with quality measurement in dentistry as observed from our previous work on refining and transforming dental quality measures into e-measures. MAIN BODY: Some examples of the unintended consequences and challenges associated with implementing dental quality measures include: a de-emphasis on patient-centeredness with process-based quality measures, an incentivization of unethical behavior due to fee-for-service reimbursement systems, the risk of compromising patient and provider autonomy with plan-level measures, a disproportionate benefits of dental quality measurement going toward payers, and the risk of alienating smaller dental offices due to the resource-intensive nature of quality measurement.

conclusionAs our medical counterparts have embraced quality measurement for improved health outcomes, so too must the dental profession. Our ultimate goal is to ensure the delivery of high quality, patient-centered dental care and effective quality measurement is the first step. By continuously monitoring the performance of dental quality measures and their continued refinement when unintended consequences are observed, we can improve patient and population health outcomes.

Indexed as

DentistryFee-for-Service PlansHumansPatient-Centered CareDentistryEthicsQualityQuality measures

Identifiers

PMID30823894
PMCPMC6397478

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.