Journal of Disability and Oral Health

cover art

Cover Date:
September 2011
Print ISSN:
1470-8558
Vol:
12
Issue:
3

Reliability of the BDA case mix tool for use in special care dentistry

Abstract Introduction: The British Dental Association (BDA) has developed a case mix tool for measuring patient complexity to aid commissioning and evaluation of special care services. The aim of this study was to explore examiner agreement when using the case mix tool. Methodology: All 143 dentists who had attended the launch and training for the BDA case mix tool were invited to take part via email. Ten hypothetical scenarios of patients with complexities were created for this study and provided to participants. Using the case mix tool guidelines, all scenarios were scored on six different criteria. These scores were compared with gold standard answer scores to measure the reliability of the tool. Internal consistency among participant’s scores was also assessed. Data on prior experience of using the case mix tool and of special care dentistry were collected. Results: Of the 41 dentists who replied to our invitation 26 agreed to take part. Cronbach’s alpha scores for the six criteria ranged from 0.37 to 0.76 with the lowest for communication and the highest for oral risk, highlighting a wide variation in internal consistency. Average Kappa scores ranged from 0.31 to 0.71 indicating a range in agreement with the gold standard. The lowest level of agreement was for oral risk and the highest for co-operation. Those with prior experience of the tool and of special care dentistry did not demonstrate improved agreement with the gold standard when compared to those without experience. Conclusion: Dentists show significant variation when assessing patient complexity using the BDA case mix tool. This has implications for the reliability of the tool among those who use it. Further development of the criteria, validation, training and regular use would improve the validity and reliability of the BDA case mix tool.

Key words: Case mix, special care dentistry

Article Price
£15.00
Institution Article Price
£
Page Start
107
Page End
113
Authors
NM Burgess, N Monaghan, M Z Morgan, R Playle, S Thompson

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