Evidence map›Paper›PMID 30931787›Full record

ArticleJDR clinical and translational research2018

Cost-effectiveness of Treating Severe Childhood Caries under General Anesthesia versus Conscious Sedation.

J M Burgette, R B Quiñonez

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in JDR clinical and translational research, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed, 1 pooled it
4.6field-weighted citation impact, top 5% of its field
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

17 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.

  1. The Use of Expert Elicitation among Computational Modeling Studies in Health Research: A Systematic Review.Medical decision making : an international journal of the Society for Medical Decision Making · 2022
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  11. Comparison of Oral Health-Related Quality of Life scores in children treated for early childhood caries under general and local anesthesia: a quasi-experimental study.European archives of paediatric dentistry : official journal of the European Academy of Paediatric Dentistry · 2023
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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

2 authors at 1 institution in 1 country.

J M Burgette1 Departments of Dental Public Health and Pediatric Dentistry, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, USA.ORCID 0000-0001-5677-6295
R B Quiñonez3 Department of Pediatric Dentistry, School of Dentistry, University of North Carolina, Chapel Hill, NC, USA.
University of North Carolina at Chapel Hill · US

Funding

UNC-CH TRAINING PROGRAM IN HEALTH SERVICES RESEARCHT32HS000032 · AHRQ · UNIV OF NORTH CAROLINA CHAPEL HILL · PI HOLMES, GEORGE M · 1989 to 2024
$8.2M
AHRQ HHS T32 HS000032
6 · The paper itself

Abstract

backgroundTwo common methods of treating pediatric dental patients with severe early childhood caries (S-ECC) are general anesthesia (GA) and conscious sedation (CS). We sought to first evaluate the cost-effectiveness of treating S-ECC with GA versus CS and then compare the cost-effectiveness at 2 time points: 2011 and 2015.

methodsWe used a decision tree model to produce 2-y estimates of costs and outcomes from the Medicaid perspective. The model cohort consisted of healthy 3-y-olds with S-ECC in need of a theoretical set of dental treatments to be performed under either a single GA visit or 3 CS visits. Outcomes were measured in caries-free months. Costs were evaluated in 2015 US dollars. Costs, probabilities, and outcomes were estimated from published data, expert opinion, and Medicaid billing at an academic health center. One-way and probabilistic sensitivity analyses were performed.

resultsAs compared with CS, GA resulted in 4 additional caries-free months per child. The cost of a caries-free month for GA versus CS rose from $596 in 2011 to $881 in 2015. These findings were sensitive to loss to follow-up for subsequent CS visits and total cost of GA.

conclusionsComprehensive S-ECC treatment had better outcomes when performed under GA versus CS. However, GA was not cost saving when compared with CS. While the cost of dental treatment increased for both GA and CS from 2011 to 2015, the cost rose faster for GA. These results have important implications due to the increasing cost to Medicaid insurance and the rising number of young children being treated for S-ECC under GA. KNOWLEDGE TRANSFER STATEMENT: Medicaid policy makers can use the results of this study to evaluate the cost-effectiveness of dental treatment for young children with S-ECC at 2 time points: 2011 and 2015. Compared with CS, GA resulted in a longer amount of time during which children were free from dental caries but at a higher cost. The cost difference rose from 2011 to 2015.

Indexed as

Anesthesia, DentalDental Care for ChildrenDental CariesAnesthesia, GeneralChildChild, PreschoolCost-Benefit AnalysisHumansProcedural SedationUnited Statescosts and cost analysisdecision makingdental care for childrendentistryMedicaidpreschool child

Identifiers

PMID30931787
PMCPMC6992433
OpenAlexW2806703021

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.