M R Heath*, (Dept of Prosthetic Dentistry and Gerodontology, The Royal London Hospital, El 2AD, England)
The climate of opinions is moving steadily towards accountability - "Evidence Based Medicine" for which suitable "Outcome Measures" (OMs) are essential for research and for audit. At the 1996 IADR, working groups were defined with the aim of i) defining/ develop OMs ii) Collect data using OMs iii) Design studies or develop models for using OMs. Starting from Caries it was realised that tooth loss is not of itself a satisfactory end measure of Outcome. A group was therefore formed to extend a structure of suitable physiological methodology. A Hierarchy of Consequence can be traced from Plaque to Tooth loss -> Occlusal deterioration Masticatory impairment -> Loss of Pleasure -> Dietary selection and sometimes to Nutritional deficiency. There are already methods for several of these stages, and for each, the measured effect of restorative treatment can provide the evidence-base for assessment of treatment. There is, as always, a trade-off between time taken and precision so the appropriateness of methodologies for detailed research through to screening large samples will be discussed. Those with relevant interests are contributing their part of the action; a group is already established but all are welcome on <M.R.Heath@mds.qmw.ac.uk>. The progress by September will be presented.