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22 Orthodontics KCE Reports 77 2.2.1.3 In- and exclusion criteria Following inclusion criteria were used throughout the evaluation of title-abstract (literature sifting): Terms: Orthodontic, treatment need, indications orthodontic treatment, syndromes, perception: patient and clinician (orthodontic practitioner), expectation patient, social desirability, subjective treatment need, quality of life Population: Newborn, Baby, Child, Adolescent, developed Western countries Language: Nederlands, Français, English, Deutsch Design: Epidemiological studies, RCTs, Reviews, Guidelines, Meta- Following exclusion criteria were used : analyses Population: Age > 15 years, non-Western countries (e.g. Tanzania, Nigeria…) Language all except those in criteria for inclusion Design: case reports, pilot studies, animal studies, editorials, comments, articles published in abstract from or conference proceedings. Topic: articles only dealing with technical aspect of the treatment (e.g. comparison of two types of adhesives); orthodontics as minor treatment in case of surgical procedures. 2.2.1.4 Selecting studies For the review of the literature epidemiological studies, randomized controlled trials, controlled clinical trials, reviews, systematic reviews, guidelines or meta-analysis were assessed. If studies with high levels of evidence were not found, consideration was also made to include study designs with lower levels of evidence to reflect the best level of evidence available on this subject. Exclusion criteria were used as mentioned above. Overall and after discarding duplicate references, 603 citations were retrieved for further study. They were read in full and critically appraised as described below. 2.2.1.5 In- and exclusion Additional to the HAS-guideline and the SBU-study (see 2.2.1.1), the search of the electronic databases yielded the following numbers of publications:
KCE Reports 77 Orthodontics 23 Figure 1: Flowchart of included and excluded studies Inclusion of relevant hand-searched studies and documents suggested by the experts at the expert meeting: 11 Reasons: - quality of life parameters not retrieved by earlier searches (journal not retrieved by Pubmed) - logopedic indications for orthodontic treatment - psychosocial and medically accepted indications of orthodontic treatment in CLP patients - consensus indications for orthodontic treatment - myofunctional indications of orthodontic treatment Potentially relevant citations identified: 8.490 2.2.2 Critical appraisal of the evidence Studies retrieved for more detailed evaluation: 603 Relevant studies : 101 Clinical orthodontic studies selected: 112 Based on title and abstract evaluation citations excluded: 7.887 Based on full text evaluation, studies excluded: 491 The methodological quality of clinical evidence was assessed according to the system proposed by Guyatt et al., 2006 3 This system considers the level of evidence (as well as the grade of recommendation), and is further explicated in Table 2. The quality of evidence can be: • High: further research is very unlikely to change our confidence in the estimate of effect • Moderate: further research is likely to have an important impact on our confidence in the estimate of the effect • Low: further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate; or any estimate of effect is very uncertain.
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Dépôt légal : D/2008/10.273/21
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35. Etude relative aux coûts poten
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