Socio-economic inequality in the self-reported number of natural teeth among Norwegian adults--an analytical study

Abstract – Objective: To assess inequality in dental status associated with educational level, gross personal and family income among Norwegian adults. Methods: Data were collected by Norway's Central Bureau of Statistics in November–December 2003. A two‐stage, proportional random sample comprising 2000 persons aged 16–79 years was drawn from the national population register. Information became available for 1309 subjects by interview. The present analyses pertain to 1092 subjects aged 25–79 years (response rate 66%, mean age 47.9 years). Results: Of the respondents, 3% were edentulous and 9% had fewer than 20 teeth. The mean number of teeth was 27.1 (SD 7.0). In multiple logistic regression analysis, low gross personal and adjusted family income were associated with increased likelihood of having fewer than 20 natural teeth (OR = 2.84, 95% CI 1.58, 5.10; OR = 3.63, 95% CI 1.99, 6.62, respectively). Educational level was significantly associated with dental status in bivariate but not in multivariate analyses, except once among males. The predictors of socio‐economic inequality in dental status accounted for a limited proportion of explained variance (Nagelkerke's R²) when controlling for age, place of residence, perceived oral health compared with others, perceived importance of oral health, dental attendance and smoking. Conclusion: Socio‐economic inequality in dental status persists among Norwegians aged 25–79 years but absolute differences have decreased during the last 30 years. The findings are encouraging but challenging as far as choice of strategy for further reduction of differences in tooth loss.     

Effect of early treatment with disease-modifying anti-rheumatic drugs and treatment adherence on disease outcome in rheumatoid arthritis patients

Aim of the work

To evaluate the effects of early and regular treatment with Disease Modifying Anti-Rheumatic Drugs (DMARDs) on disease outcome in rheumatoid arthritis (RA) patients and factors affecting adherence to treatment.

The role of magnetic resonance imaging in early detection of recurrent breast cancer

Purpose

The purpose of this work was the evaluation of new advances of magnetic resonance imaging (MRI) in diagnosis of recurrent breast cancer after conservative surgery, chemotherapy and radiotherapy.

Tonsil surgery in Sweden 2013–2015. Indications,surgical methods and patient-reported outcomes from the National Tonsil Surgery Register

Aim: To describes how tonsil surgery was performed in Sweden from 2013 to 2015 with data from the National Tonsil Surgery Registry in Sweden (NTSRS).

Method: The registry collects data from both professionals and patients through questionnaires. A total of 33,870 tonsil surgeries were analysed, comprising approximately 80% of all tonsil surgeries in Sweden from 2013 to 2015.

Results: The two most common procedures were tonsillectomy (41%) and tonsillotomy with adenoidectomy (38%). Tonsillectomy was most commonly performed to treat frequent tonsillitis, while the main indication for tonsil surgery with combined adenoidectomy and for tonsillotomy alone was upper airway obstruction. The most commonly used techniques were cold steel (70%) for tonsillectomy/adenotonsillectomy and radiofrequency (79%) for tonsillotomy/adenotonsillotomy. Ninety-five percent of patients reported symptom relief after 180 d. Day surgery was utilised in 70% of the surgeries. The rate of readmission due to post-tonsillectomy haemorrhage was 5.1%. Male patients more often underwent tonsil surgery at preschool ages due to upper airway obstruction; in comparison, female patients to a larger extent underwent surgery in their early teens because of previous infections.

Conclusions: The NTSRS provides an opportunity to survey tonsil surgery in Sweden and to launch and follow up improvement programmes as desired.     

The effect of non-response on estimates of health care utilisation: linking health surveys and registers

BACKGROUND: Non-response in health surveys may lead to bias in estimates of health care utilisation. The magnitude, direction and composition of the bias are usually not well known. When data from health surveys are merged with data from registers at the individual level, analyses can reveal non-response bias. Our aim was to estimate the composition, direction and magnitude of non-response bias in the estimation of health care costs in two types of health interview surveys. METHODS: The surveys were (1) a national personal interview survey of 22 484 Danes (2) a telephone interview survey of 5000 Danes living in Funen County. Data were linked with register information on health care utilisation in hospitals and primary care. Health care utilisation was estimated for respondents and non-respondents, and the difference was explained by a decomposition method of bias components. RESULTS: The surveys produced the same pattern of non-response, but with slight differences in non-response bias. Response rates for the interview and telephone surveys were 75 and 69%, respectively. Refusal was the most frequent reason for non-response (22 and 20% of those sampled, respectively), whereas illness, non-contact, and other reasons were less frequent. Respondents used 3-6% less health care than non-respondents at the aggregate level, but the opposite was true for some specific types of health care. Non-response due to illness was the main contributor to non-response bias. CONCLUSIONS: Different types of non-response have different bias effects. However, the magnitude of the bias encourages the continued use of interview health surveys.     

The role of technology in video-mediated consensus meetings

We have studied the use of video-mediated technology to facilitate multidisciplinary meetings where consensus is reached about the diagnosis and treatment of patients. The meetings involved 2-5 sites, with 1-20 participants from each site, and concerned patients with severe diseases in the upper abdomen. During a period of about one year we conducted observations and interviews at the Karolinska hospital and some of the local hospitals. Eight video-mediated consensus meetings were video-recorded and transcribed. The audio and the radiology images presented during the meetings were considered to be most important; video was not critical for the consensus meeting itself, but contributed to a feeling of awareness and social presence. We conclude that video-mediated consensus meetings are affected by the technology used, and certain changes in the technology or environment could improve the meetings. Without the technology, such meetings would lead to more travelling for the patient and for the medical staff involved.