Assessment of outcome measures used in two high-ranked endodontic journals according to a hierarchical model

Abstract

Aim (1) to develop a hierarchical model on outcome measures related to endodontic treatments and (2) systematically assess the outcome measures used in studies on treatment(s) in two high-ranked endodontic journals according to the developed hierarchical model.

Methodology Based on the Fryback and Thornbury hierarchical model of efficacy used in diagnostic imaging, a conceptual model on treatment effect/efficacy/effectiveness was developed. Consecutive numbers of the two highest ranked endodontic journals, the International Endodontic Journal and the Journal of Endodontics, were individually reviewed by the authors to identify original scientific studies and systematic reviews related to any form of treatment. After reading the articles in full-text and using a pre-defined protocol, the reported treatment outcomes were assessed to be on a certain level on the conceptual model. Consensus was reached by discussion.

Results The highest level in the proposed model ´Societal´, is exemplified by the outcome measure cost-effectiveness. The lowest level in the proposed model ´Technical´, is exemplified by the outcome measure torsional fracture of endodontic instruments in an ex vivo model. Preliminary results indicate few original scientific studies or systematic reviews to report outcome measures on the higher levels of the hierarchical model, and the majority of studies were assessed to be on the lower levels.

Conclusions The preliminary results of this study propose that the majority of studies on endodontic treatments are designed to evaluate technical aspects of treatment procedures, and few evaluate treatments from a societal perspective. This does not necessarily mean that the quality per se of the studies is poor, or that the studies are redundant but points to the need of reflection when deciding on future research activities within the field of endodontics.