En valideringsstudie av Proview (Bausch & Lomb) Pressure Phosphene Tonometer hvor effekten av opplæring og erfaring undersøkes

Målsetting: Vi ville finne ut i hvilken grad opplæring i bruk av Proview (PPT) og erfaring fra gjentatte målinger påvirker instrumentets kliniske anvendelighet sammenlignet med iCare og Goldmann applanasjonstonometer. Metode: Dette var en prospektiv eksperimentell valideringsstudie der studiepopulasjon ble delt i to grupper, hvor den ene mottok grundig opplæring i PPTog den andre hadde en kort selvstudiebasert opplæring. Vi utførte så tre målesesjoner over tre uker. Resultater: Tendensen var at intervensjonsgruppen viste en lavere gjennomsnittlig differanse enn kontrollgruppen mellom PPT og de to andre instrumentene, men spredningen var stor og differansen var ikke statistisk signifikant. Intervensjonsgruppen viste en reduksjon i gjennomsnittlig differanse, med en signifikant forskjell over gjentatte målinger (p.verdi: 0,018) for iCare-PPT, mens den ikke var signifikant for GAT-PPT. Kontrollgruppen viste samme tendens, uten at forskjellen ble signifikant. Konklusjon: Vi fant ingen signifikant effekt av opplæringen, men så en tendens til læringseffekt over gjentatte målinger

Variation in costs of cone beam CT examinations among healthcare systems

Objectives: To analyse the costs of cone beam CT (CBCT) in different healthcare systems for patients with different clinical conditions. Methods: Costs were calculated for CBCT performed in Cluj (Romania), Leuven (Belgium), Malmö (Sweden) and Vilnius (Lithuania) on patients with (i) a maxillary canine with eruption disturbance, (ii) an area with tooth loss prior to implant treatment or (iii) a lower wisdom tooth planned for removal. The costs were calculated using an approach based on the identification, measurement and valuation of all resources used in the delivery of the service that combined direct costs (capital equipment, accommodation, labour) with indirect costs (patients' and accompanying persons' time, "out of pocket" costs for examination fee and visits). Results: The estimates for direct and indirect costs varied among the healthcare systems, being highest in Malmö and lowest in Leuven. Variation in direct costs was mainly owing to different capital costs for the CBCT equipment arising from differences in purchase prices (range J148 000-227 000). Variation in indirect costs were mainly owing to examination fees (range J0-102.02). Conclusions: Cost analysis provides an important input for economic evaluations of diagnostic methods in different healthcare systems and for planning of service delivery. Additionally, it enables decision-makers to separate variations in costs between systems into those due to external influences and those due to policy decisions. A cost evaluation of a dental radiographic method cannot be generalized from one healthcare system to another, but must take into account these specific circumstances