| 应用Delphi法构建下颌阻生第三磨牙拔除难度评分量表 |
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| 引用本文： | 陈震,谷宝鑫,汤玉芳,闫子玉,倪方端,崔念晖. 应用Delphi法构建下颌阻生第三磨牙拔除难度评分量表[J]. 北京大学学报(医学版), 2022, 54(1): 100-104. DOI: 10.19723/j.issn.1671-167X.2022.01.016 |
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| 作者姓名： | 陈震 谷宝鑫 汤玉芳 闫子玉 倪方端 崔念晖 |
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| 作者单位： | 北京大学口腔医学院·口腔医院口腔颌面外科,国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔数字化医疗技术和材料国家工程实验室,口腔数字医学北京市重点实验室,国家卫生健康委员会口腔医学计算机应用工程技术研究中心,国家药品监督管理局口腔生物材料重点实验室,北京 100081 |
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| 基金项目： | 北京大学口腔医院新技术新疗法项目(PKUSSNCT-20B09) |
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| 摘 要： | 目的: 评估影响下颌阻生第三磨牙拔除难度的相关指标,对不同操作和风险指标进行难度评分,构建出直观且准确的下颌阻生第三磨牙拔除难度评分量表,以期帮助医生在术前对手术难度进行更加准确的分析与预测。方法: 以文献和临床回顾为基础,汇总拔牙难度指标。首先由10位来自北京大学口腔医院长期从事牙槽外科专业工作的医师组建专家名义小组,以面对面发放问卷的形式,请专家对汇总的拔牙难度指标是否需要保留进行打分,经商议后形成评估下颌阻生第三磨牙拔除难度一、二级条目框架;再采用Delphi专家咨询法通过电子邮件的方式向30名Delphi专家发送问卷,经过两轮打分及修改,形成下颌阻生第三磨牙拔除难度评分量表。结果: 两轮问卷回收率均为100.0%,即专家的积极系数(Cj)均为100%;两轮Delphi专家咨询的权威系数(Cr)为0.92,说明结果具有一定代表性和权威性;经过两轮打分及修改,专家打分变异系数(CV)变小,意见协调系数(W)升高,均有统计学显著意义[第一轮CV为0.24,W为0.56(P<0.001);第二轮CV为0.19,W为0.72(P<0.001)],说明专家意见有较好的趋同性。最终形成含有12个一级指标和37个二级指标的下颌阻生第三磨牙拔除难度评分量表,包含操作难度指标项、风险难度指标项和共同难度指标项。结论: 在进行全面文献检索的基础上,提出下颌阻生第三磨牙拔除难度由操作难度和风险难度共同构成的观点,采用Delphi专家咨询法,将专家长期的临床经验、专业知识转化成量化指标,作为拔牙难度预测的评分量表,具有一定的代表性和权威性。
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| 关 键 词： | 下颌阻生第三磨牙 牙拔除术 难度评估 Delphi专家咨询法 |
| 收稿时间： | 2021-10-11 |
Constructions of the scale of difficulty in the extraction of impacted mandibular third molars by using Delphi method |
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| CHEN Zhen,GU Bao-xin,TANG Yu-fang,YAN Zi-yu,NI Fang-duan,CUI Nian-hui. Constructions of the scale of difficulty in the extraction of impacted mandibular third molars by using Delphi method[J]. Journal of Peking University. Health sciences, 2022, 54(1): 100-104. DOI: 10.19723/j.issn.1671-167X.2022.01.016 |
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| Authors: | CHEN Zhen GU Bao-xin TANG Yu-fang YAN Zi-yu NI Fang-duan CUI Nian-hui |
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| Abstract: | Objective: To evaluate the relevant indicators affecting difficulty in the extraction of impacted mandibular third molars and score difficulty of different operation and risk indicators, so as to build an intuitive and accurate scale to help operators make more accurate analysis and prediction of difficulty before the operation. Methods: Based on literature and the clinical review, the difficulty indicators of tooth extraction were summarized. Firstly, 10 doctors from Peking University School and Hospital of Stomatology who had been engaged in alveolar surgery for a long time established an expert nominal group, and then rated whether the summarized indicators needed to be retained in the form of face-to-face questionnaires. A level 1 and 2 item frame for evaluating difficulty in the tooth extraction was formed after discussion; Then Delphi method was used to send a questionnaire to 30 experts by e-mail. After two rounds of scoring and modification, the scale of difficulty in the extraction of impacted mandibular third molars was formed. Results: The recycling rate of two rounds of questionnaires was 100.0%,which showed that the experts were very enthusiastic about the study; The authority coefficients (Cr) of the two rounds of Delphi expert consultation were both 0.92, which showed that the results were representative and authoritative. After two rounds of grading and revision, the variable coefficient (CV) decreased and the Kendall’s concordance coefficient (W) increased, which were statistically significant: In the first round, the CV was 0.24 and W was 0.56 (P<0.001), and in the second, the CV was 0.19 and W was 0.72 (P<0.001), which indicated that there was a good convergence among the expert opinions. Finally, a scale of difficulty in the tooth extraction containing 12 items at level A and 37 items at level B was formed, including operation difficulty indicators, risk difficulty indicators and common difficulty indicators. Conclusion: Based on comprehensive literature retrieval, the study has put forward the concept that difficulty in the extraction of impacted mandibular third molars is composed of operation difficulty and risk difficulty. Using Delphi method, the long-term clinical experience and professional knowledge of experts are transformed into quantitative indicators as a scoring scale. The scale has certain representativeness and authority. |
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| Keywords: | Impacted mandibular third molars Tooth extraction The scale of difficulty Delphi method |
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