work package 5 cost effectiveness participant responsible mahod participants contributing cluj kul...
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Work package 5
Cost effectiveness
Participant responsibleMAHOD
Participants contributingCLUJ KUL
UNIMANVU
SEDENTEXCT consortium meeting Malmö, January 2010
To analyse the cost-effectiveness of
CBCT in different clinical situations,
health care contexts and countries
Overall objective of WP 5
Specific objectives
• To analyse the costs of CBCT examinations in terms of radiation dosage and monetary terms
• To analyse additional diagnostic information • To analyse additional therapeutical information• To calculate costs and efficacy for different clinical
situations i.e the gain of CBCT in terms of efficacy
Clinical situations agreed on
Retained maxillary canines
Lower wisdom teeth
Preoperative implants
Temporomandibular joints
Conventionalmethod
New method
Conventionalmethod
New method
COST-EFFECTIVENESS
COST ANALYSIS ANALYSIS OF CONSEQUENCES
D5.1 Analysis of time and cost spent on the ”key” CBCT examination in all participating radiology departments – M5.2, M 18
Valuation of cost per image of intraoral and panoraminc radiographs and volumes of CBCT in EURO.
Intra-oral Panoramic CBCT
Malmö 4,02 16,12 105,42 Cluj 2,42 3,79 36,44 Leuven 1,26 1,45 24,28 Vilnius 1,95 2,25 68,26 Average 2,41 5,90 58,6
Worked on further…..
Objectives for year 2
Milestone Delivery date
5.2 Cost analysis Month 24
5.3 WP5 clinical case collection completed
Month 21
5.5 WP5 diagnosis and treatment plan completed
Month 24
Milestone Delivery date
5.2 Cost analysis Month 24
5.3 WP5 clinical case collection completed
Month 21
5.4 Assessment of WP5 radiographs completed
Month 21
5.5 WP5 diagnosis and treatment plan completed
Month 24
Number of received patient protocols December 21, 2009
Retained canines
Implants Lower wisdom
teeth
TMJ
Cluj 9 50 24 3
Leuven 34
Malmö 51 65 35 20
Vilnius 35 50 31
Summary 129 165 90 23
Problems identified:
• recruitment of patients• patients examined with only one radiographic method (CBCT) in some centres • transfer of images to MAHOD
Problem solving:
• continuous recruitment of patients in MAHOD• UNIMAN entering clinical cases into WP5
Milestone Delivery date
5.2 Cost analysis Month 24
5.3 WP5 clinical case collection completed
Month 21
5.4 Assessment of WP5 radiographs completed
Month 21
5.5 WP5 diagnosis and treatment plan completed
Month 24
ANALYSIS OF CONSEQUENCES
Influence on the confidence of the radiologist – diagnostic thinking efficacy (M5.4)
Influence on the confidence of the clinicianin treatment decision (M5.5)
Influence on the treatment
Consequences for the patient
Retained canine Observer ………………..… Observation ………………. Date …………… Assessment of panoramic and intra-oral radiography Patient id:………………………. Canine: ………………. Name:…………………………………………………….. Impacted canine How confident are you in your
assessment?
Position YES NO Not confident Very confident Mediolateral position
NOT POSSIBLE TO ASSESS
Horisontal Vertical Mesioangular Distoangular Bucco-lingual position Crown central Crown buccal Crown palatal Root central Root buccal Root palatal Distance crown to marginal bone Crown tip through marginal bone 1 – 5mm from marginal bone 5 – 10mm from marginal bone > 10mm from marginal bone Not possible to assess Root morphology Root with open apex Root with closed apex Root curve or flex Curve at inferior 1/3 of root Curve at inferior 2/3 of root Curve at apical 1/3 of root Curve in buccal direction Curve in palatal direction Curve in mesial direction Curve in distal direction Follicular size < 3mm 3-5mm > 5mm
Resorption of neighbouring root Central incisor Lateral incisor First premolar Root resorption definitely not present Root resorption definitely not present Root resorption definitely not present Root resorption probably not present Root resorption probably not present Root resorption probably not present Unsure (uncertain) Unsure (uncertain) Unsure (uncertain) Root resorption probably present Root resorption probably present Root resorption probably present Root resorption definitely present Root resorption definitely present Root resorption definitely present IF resorption is present or probably present
How confident are you in your assessment?
Tooth…. Not confident Very confident Amount of resorption Superficial Reaching ½ to pulp Reaching pulp Not possible to assess Placement of resorption Mainly apical Mainly buccal Mainly palatal Mainly distal Mainly mesial Mainly other Tooth….
Amount of resorption Superficial Reaching ½ to pulp Reaching pulp Not possible to assess Placement of resorption Mainly apical Mainly buccal Mainly palatal Mainly distal Mainly mesial Mainly other Comments: ………………………………………………………………………………………………………………………………………… Time for assessment…………minut
Problems identified:
• recruitment of patients• patients examined with only one radiographic method (CBCT) in some centres • transfer of images to MAHOD
Milestone Delivery date
5.2 Cost analysis Month 24
5.3 WP5 clinical case collection completed
Month 21
5.4 Assessment of WP5 radiographs completed
Month 21
5.5 WP5 diagnosis and treatment plan completed
Month 24
Plans for Month 24 - 36
Month 27
M 5.4Retained canines and wisdom teeth
Month 30
M 5.5Retainedcanines
Month 32
M 5.5Wisdom teeth andImplant patients
Month 26
M 5.6Avalaibility of WP2dosimetry data forWP5 work
M 5.7 and 5.8Completion ofWP5 work
D5.2Completion of cost analysis of CBCT
D5.2, M26Completion of cost analysis of CBCT
D5.3, M36Analysis and calculations of cost-effectiveess completed