Evidence map›Paper›PMID 31907022›Full record

Trial reportTrials2020

Comparing how patients value and respond to information on risk given in three different forms during dental check-ups: the PREFER randomised controlled trial.

R Harris, V Lowers, L Laverty, C Vernazza, G Burnside, S Brown, L Ternent

Abstract readComparative StudyMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in Trials, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 2 pooled it
–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, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Article
  5. Article
  6. Prevalence of Missing Values and Protest Zeros in Contingent Valuation in Dental Medicine.International journal of environmental research and public health · 2021
    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.

R HarrisDepartment of Health Services Research, Institute of Population Health Sciences, University of Liverpool, Room 124, 1st Floor Block B, Waterhouse Building, 1-5 Brownlow Hill, Liverpool, L69 3GL, UK. harrisrv@liverpool.ac.uk.ORCID http://orcid.org/0000-0002-5891-6826
V LowersDepartment of Health Services Research, Institute of Population Health Sciences, University of Liverpool, Room 124, 1st Floor Block B, Waterhouse Building, 1-5 Brownlow Hill, Liverpool, L69 3GL, UK.
L LavertyDepartment of Health Services Research, Institute of Population Health Sciences, University of Liverpool, Room 124, 1st Floor Block B, Waterhouse Building, 1-5 Brownlow Hill, Liverpool, L69 3GL, UK.
C VernazzaSchool of Dental Sciences, Newcastle University, Newcastle-upon-Tyne, Tyne and Wear, UK.
G BurnsideDepartment of Biostatistics, Institute of Translational Medicine, University of Liverpool, Liverpool, UK.
S BrownDepartment of Health Services Research, Institute of Population Health Sciences, University of Liverpool, Room 124, 1st Floor Block B, Waterhouse Building, 1-5 Brownlow Hill, Liverpool, L69 3GL, UK.
L TernentInstitute of Health and Society, Newcastle University, Newcastle-upon-Tyne, Tyne and Wear, UK.

Funding

Department of Health CS-2014-14-011Department of Health HS&DR/13/33/45National Institute for Health Research 13/33/45
6 · The paper itself

Abstract

backgroundThis study aims to compare patient preference for, and subsequent change in, oral health behaviour for three forms of risk information given at dental check-ups (verbal advice compared to verbal advice accompanied by a traffic light (TL) risk card; or compared to verbal advice with a quantitative light fluorescence (QLF) photograph of the patient's mouth).

methodsA multi-centre, parallel-group, patient-randomised clinical trial was undertaken between August 2015 and September 2016. Computer-generated random numbers using block stratification allocated patients to three arms. The setting was four English NHS dental practices. Participants were 412 dentate adults at medium/high risk of poor oral health. Patients rated preference and willingness to pay (WTP) for the three types of information. The primary outcome was WTP. After receiving their check-up, patients received the type of information according to their group allocation. Follow-up was by telephone/e-mail at 6 and 12 months. Mean and median WTP for the three arms were compared using Wilcoxon signed-rank tests. Tobit regression models were used to investigate factors affecting WTP and preference for information type. Secondary outcomes included self-rated oral health and change in oral health behaviours (tooth-brushing, sugar consumption and smoking) and were investigated using multivariate generalised linear mixed models.

resultsA total of 412 patients were randomised (138 to verbal, 134 to TL and 140 to QLF); 391 revisited their WTP scores after the check-up (23 withdrew). Follow-up data were obtained for 185 (46%) participants at 6 months and 153 (38%) participants at 12 months. Verbal advice was the first preference for 51% (209 participants), QLF for 35% (145 participants) and TL for 14% (58 participants). TL information was valued lower than either verbal or QLF information (p < 0.0001). Practice attended was predictive of verbal as first preference, and being older. Practice attended, preferring TL the most and having fewer than 20 teeth were associated with increased WTP; and living in a relatively deprived area or having low literacy decreased WTP. There were no significant differences in behaviour change on follow-up.

conclusionsAlthough a new NHS dental contract based on TL risk stratification is being tested, patients prefer the usual verbal advice. There was also a practice effect which will needs to be considered for successful implementation of this government policy.

trial registrationISRCTN, ISRCTN71242343. Retrospectively registered on 27 March 2018.

Indexed as

Health Plan ImplementationOral HealthPatient PreferenceAdolescentAdultAgedDental CareFemaleHealth PolicyHumansMaleMiddle AgedPatient Education as TopicState MedicineUnited KingdomYoung AdultBehaviour changeCommunicationDental practiceHealth educationOral healthRisk

Identifiers

PMID31907022
PMCPMC6945632

What OpenQuestion holds

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Registered trials

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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.