"Over-reviewing" of research? An analysis of orthodontic reviews

INTRODUCTION: Research overviews may be undertaken to identify gaps in the literature, evaluate existing systematic reviews (SRs), and summarize evidence. This paper aims to profile overviews that have been conducted in orthodontics and related interventions since 2012 and to evaluate the degree of overlap among these overviews. METHODS: Overviews published between January 1, 2012 and June 20, 2023 were identified using an electronic search involving Google Scholar and PubMed. A descriptive summary was produced, and citation matrices were used to evaluate the percentage of overlap between overviews using corrected covered area and covered area. This was classified as slight, moderate, high, or very high. RESULTS: A total of 35 overviews were identified across a wide range of topics. Eight overviews included 20 SRs (median no. of SRs per overview, 15; range, 3-62). Meta-analysis was conducted in only 5 overviews. Overlap between overviews on the same topic ranged from slight (2.7%) to very high (53.8%). CONCLUSIONS: Almost all overview topics address treatments and their effects, with a wide variation in the number and quality of SRs included. There is considerable overlap in some orthodontic overviews, suggesting unnecessary duplication and research waste. Researchers should be encouraged to focus on primary data collection to add more high-quality data to SRs, which will ultimately enhance the yield from secondary and tertiary orthodontic research

Development of a core outcome set for orthodontic trials using a mixed-methods approach: Protocol for a multicentre study

© 2017 The Author(s). Background: Orthodontic treatment is commonly undertaken in young people, with over 40% of children in the UK needing treatment and currently one third having treatment, at a cost to the National Health Service in England and Wales of £273 million each year. Most current research about orthodontic care does not consider what patients truly feel about, or want, from treatment, and a diverse range of outcomes is being used with little consistency between studies. This study aims to address these problems, using established methodology to develop a core outcome set for use in future clinical trials of orthodontic interventions in children and young people. Methods/design: This is a mixed-methods study incorporating four distinct stages. The first stage will include a scoping review of the scientific literature to identify primary and secondary outcome measures that have been used in previous orthodontic clinical trials. The second stage will involve qualitative interviews and focus groups with orthodontic patients aged 10 to 16 years to determine what outcomes are important to them. The outcomes elicited from these two stages will inform the third stage of the study in which a long-list of outcomes will be ranked in terms of importance using electronic Delphi surveys involving clinicians and patients. The final stage of the study will involve face-to-face consensus meetings with all stakeholders to discuss and agree on the outcome measures that should be included in the final core outcome set. Discussion: This research will help to inform patients, parents, clinicians and commissioners about outcomes that are important to young people undergoing orthodontic treatment. Adoption of the core outcome set in future clinical trials of orthodontic treatment will make it easier for results to be compared, contrasted and combined. This should translate into improved decision-making by all stakeholders involved. Trial registration: The project has been registered on the Core Outcome Measures in Effectiveness Trials (COMET) website, January 2016

Development of a standardised set of outcome measures for use in routine orthodontic clinical trials

PhD ThesisAims: To develop an agreed, standardised set of outcome measures for use in clinical trials of routine orthodontic treatment for non-cleft/orthognathic patients. Methods: A mixed-methods approach was used. In stage I, a list of outcomes measured in previous orthodontic research was identified through a scoping literature review following standardised methodology. Further outcomes of importance to patients were obtained using qualitative interviews and focus groups involving adolescents at different stages of treatment in five centres in stage II. Identified qualitative themes were subsequently converted into outcomes and triangulated with those from the scoping review. In stage III, rating of outcomes identified from stages I and II was carried out in a two-round electronic Delphi process involving healthcare professionals and patients using a nine-point scale. A face-to-face meeting was subsequently held with a sample of participants from the Delphi surveys in stage IV to discuss the results of the e- Delphi and reach consensus before refining the core outcome set. Results: Fifty-four outcomes were identified from the literature, with the most frequently measured being pain, periodontal health and tooth angulation/inclination changes. Dental aesthetics, function, social interactions, emotional well-being and self-perception were emergent major qualitative themes, with a total of 56 themes being identified and subsequently converted into outcomes. Following triangulation and piloting of outcomes identified from these two stages, a final list of 34 outcomes grouped under 10 domains was obtained for scoring in the e-Delphi surveys. Fifteen outcomes were voted “in” following the second Delphi round involving 274 participants, with five outcomes having “no” consensus and a further outcome being voted “in” following the consensus meeting. These were subsequently refined into a final set of seven core outcomes, including patient-related adherence, breakages, adverse effects on teeth or teethsupporting structures, impact of self-perceived aesthetics, alignment and/or occlusion, skeletal relationship and stability. Conclusions: A diverse range of outcomes is used in orthodontic research with a focus on measuring outcomes important to clinicians, and little consistency among studies in outcome selection and measurement. A bespoke, orthodontic core outcome set encompassing both clinician- and patient- focused outcomes was developed. It is anticipated that this will be incorporated into future orthodontic research studies providing a more holistic assessment of the impact of treatment while allowing for meaningful comparison and synthesis of results from individual trials

Kommandiittiyhtiön muuttaminen osakeyhtiöksi

Opinnäytetyössä tutkittiin kommandiittiyhtiön ja osakeyhtiön välisiä rakenteellisia ja verotuksellisia eroavaisuuksia. Opinnäytetyömme tavoitteena oli selvittää, miten yritysmuodot eroavat toisistaan, miten yritysmuodon muutos tapahtuu ja onko yritysmuodon muutos kannattava verotuksellisesta näkökulmasta katsottuna. Toimeksiantajana on fysioterapiapalveluita tuottava yritys, joka on suunnitellut yritysmuodon muuttamista kommandiittiyhtiöstä osakeyhtiöksi. Yritysmuodon muutos on ajankohtainen toimeksiantajalle, sillä yrityksen toiminta on laajentunut ja verotus on korkea nykyisenä yhtiömuotona. Opinnäytetyömme on tapaustutkimus, jossa on kvalitatiivisen tutkimuksen piirteitä. Pyrimme löytämään toimeksiantajalle sopivan ratkaisun, emme yleispätevää vastausta ongelmaan. Viitekehys koostuu yritystoimintaa säätelevistä laeista ja alan kirjallisuudesta. Empiirisenä aineistona käytettiin toimeksiantajan tilinpäätöstietoja ja haastattelua, joiden pohjalta laadittiin laskelmia yritysmuotojen verotuksesta. Kommandiittiyhtiö ja osakeyhtiö ovat lähtökohtaisesti hallinnoltaan erilaiset, mutta toimeksiantajamme kohdalla muutos ei ole suuri, sillä yhden miehen yhtiössä byrokratiaa on hyvin vähän. Yhtiön ainut omistaja voi toimia yksin yhtiökokouksessa ja hallituksessa. Osakeyhtiössä vastuu on rajoitetumpaa ja varojenjako tarkemmin säänneltyä kuin kommandiittiyhtiössä, jossa voi tehdä rajattomasti yksityisottoja ilman vaikutusta verotukseen. Osakeyhtiöstä saa jakaa vain jakokelpoisia varoja yhtiökokouksen päätöksellä. Kommandiittiyhtiötä verotetaan elinkeinoyhtymä, ja osakeyhtiö on erillinen verovelvollinen. Laskelmien perusteella todettiin, että yritysmuodon muutos olisi verotuksellisesti kannattavaa kaikissa lasketuissa vaihtoehdoissa. Osakeyhtiön laskelmissa on tarkasteltu eri vaihtoehtoja, joissa palkan ja osingon määrä vaihtelee. Suosituksemme toimeksiantajalle on, että hänelle maksetaan palkkaa 5 000 euroa kuukaudessa ja nostettava osingon määrä on puolet yhtiön tuloksesta. Tällöin puolet tuloksesta jää kasvattamaan osakeyhtiön nettovarallisuutta, mikä kasvattaa verovapaan osingon määrää seuraavan tilinpäätöksen yhteydessä.The aim of this thesis was to study the structural and fiscal differences between a Limited Partnership and a Limited Company. The objective of the thesis was to clarify what the key differences between the company forms are, how the form of the company can be changed and if the change would be profitable from a fiscal point of view. The commissioner of this thesis is a company which produces physiotherapy services. The commissioner has been planning to change the company form from a Limited Partnership to a Limited Company. The reason for this plan is that the operations of the commissioner have increased in the near past and, therefore, taxation is quite high as a Limited Partnership. This thesis work is a case study with features of qualitative study which means that the objective is to find the most suitable option for the commissioner instead of a generic solution to the problem. The theoretical framework consists of discussions of laws which regulate entrepreneurship and discussions of the topics as conducted in relevant literature. Calculations were based on empiric materials consisting of the commissioner’s financial statements and interview. In principle Limited Partnership and Limited Company differ from each other in administration. However, when considering the commissioner the difference is not that significant because there is only one owner who can make decisions by themself in general meeting and board. In the Limited Company the responsibilities are more restricted and the profit sharing is more regulated than in the Limited Partnership. In a Limited Partnership it is easier to withdraw assets from the company. Withdrawing assets does not affect taxation. In Limited Company it is only allowed to share non-tied equity with general meeting’s decision. Based on the calculations company would achieve benefits in taxation if it was Limited Company. In the calculations the amount of salary and dividend varies between the alternatives. Our recommendation for the commissioner is salary of 5 000 euros and amount of dividend is half of the Limited Company’s profit. In this option half of the profit is left in the company to increase its net property which lightens the taxation of dividend in the next dividend distribution

The influence of mobile applications and social media-based interventions in producing behavior change among orthodontic patients: A systematic review and meta-analysis.

INTRODUCTION The objective of this project was to systematically review the effectiveness of mobile applications and social media-based interventions in producing a behavioral change in orthodontic patients. METHODS Electronic databases and reference lists of relevant studies were searched on March 1, 2021, with no language restrictions (PROSPERO: CRD42019157298). Randomized and nonrandomized controlled trials assessing the impact of mobile applications and social media-based interventions on orthodontic patients were identified. Primary outcomes included adherence to wear, appointment attendance, knowledge, oral health-related behaviors, oral hygiene levels, periodontal outcomes, and related iatrogenic effects. The quality of the included trials was assessed using the Cochrane risk of bias tools. A weighted treatment effect of interventions on periodontal outcomes was calculated. Certainty of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation system. RESULTS A total of 3617 articles were identified. Of these, 16 studies (14 randomized controlled trials and 2 nonrandomized controlled trials) were deemed eligible. Nine randomized controlled trials were judged to be of either low or unclear risk of bias. The intervention was favored in relation to gingival and plaque indexes, standardized mean difference: -0.81 (95% confidence intervals [CI], -1.35 to -0.28) and -0.91 (95% CI, -1.64 to -0.19), respectively. However, no significant effect was observed in bleeding on probing (standardized mean difference: -0.22; 95% CI, -0.5 to 0.05). The level of evidence was high in probing depth and bleeding on probing outcomes. CONCLUSIONS A very low to moderate level of evidence supports the effects of mobile applications and social media-based interventions in producing positive behavioral changes in orthodontic patients. Further high-quality trials would assist in further elucidating the potential of these approaches to influence orthodontic treatment outcomes and experiences

Development of a core outcome set for use in routine orthodontic clinical trials

Introduction A diverse range of outcomes is used in orthodontic research with a focus on measuring outcomes important to clinicians and little consistency in outcome selection and measurement. We aimed to develop a core outcome set for use in clinical trials of orthodontic treatment not involving cleft or orthognathic patient groups. Methods A list of outcomes measured in previous orthodontic research was identified through a scoping literature review. Additional outcomes of importance to patients were obtained using qualitative interviews and focus groups with adolescents aged 10-16 years. Rating of outcomes was carried out in a 2-round electronic Delphi process involving health care professionals and patients using a 9-point scale. A face-to-face meeting was subsequently held with stakeholders to discuss the results before refining the core outcome set. Results After triangulation, a final list of 34 outcomes grouped under 10 domains was obtained for rating in the e-Delphi surveys. Fifteen outcomes were voted “in” after the second Delphi round involving 274 participants with a further outcome being included after the consensus meeting. These were subsequently refined into a final set of 7 core outcomes, including the impact of self-perceived esthetics, alignment and/or occlusion, skeletal relationship, stability, patient-related adherence, breakages, and adverse effects on teeth or teeth-supporting structures. Conclusions A bespoke orthodontic core outcome set encompassing both clinician- and patient-focused outcomes was developed. Incorporating this is the first step into providing a more holistic assessment of the impact of treatment while allowing for meaningful comparisons and synthesis of results from individual trials

"Over-reviewing" of research?:An analysis of orthodontic reviews

INTRODUCTION: Research overviews may be undertaken to identify gaps in the literature, evaluate existing systematic reviews (SRs), and summarize evidence. This paper aims to profile overviews that have been conducted in orthodontics and related interventions since 2012 and to evaluate the degree of overlap among these overviews.METHODS: Overviews published between January 1, 2012 and June 20, 2023 were identified using an electronic search involving Google Scholar and PubMed. A descriptive summary was produced, and citation matrices were used to evaluate the percentage of overlap between overviews using corrected covered area and covered area. This was classified as slight, moderate, high, or very high.RESULTS: A total of 35 overviews were identified across a wide range of topics. Eight overviews included &lt;10 SRs; 21 had 10-20 SRs; and 6 included &gt;20 SRs (median no. of SRs per overview, 15; range, 3-62). Meta-analysis was conducted in only 5 overviews. Overlap between overviews on the same topic ranged from slight (2.7%) to very high (53.8%).CONCLUSIONS: Almost all overview topics address treatments and their effects, with a wide variation in the number and quality of SRs included. There is considerable overlap in some orthodontic overviews, suggesting unnecessary duplication and research waste. Researchers should be encouraged to focus on primary data collection to add more high-quality data to SRs, which will ultimately enhance the yield from secondary and tertiary orthodontic research.</p