Value in Oral and Maxillofacial Surgery: A Systematic Review of Economic Analyses

Publication date: Available online 18 May 2017
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Benjamin Geisler, Yisi D. Ji, Zachary S. Peacock
PurposeThe purpose of this study is to describe the state of economic analyses in the field of oral and maxillofacial surgery (OMS).MethodsA systematic search of published literature up to 2016 was performed. Inclusion criteria were as follows: English language articles on economic analyses pertaining to OMS including anesthesia/pain management, dentoalveolar, orthognathic/cleft/obstructive sleep apnea (OSA), pathology, reconstruction, temporomandibular disorders, trauma, and other. Exclusion criteria were as follows: opinion or perspective articles, studies unrelated to OMS, non-human research, and implant-related studies. Cost-effectiveness analyses (CEAs), cost-utility analyses (CUAs) and cost-minimization analyses (CMAs) were evaluated with the original or a modified Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist.ResultsThe search yielded 798 articles, 77 of which met inclusion criteria (1980 to 2016, 48 from the United States). There were an increasing number of studies over time (p for trend<0.01). There were seven economic studies on anesthesia/pain management (9.1%), 16 studies on dentoalveolar surgery (20.7%), 15 studies on orthognathic/cleft/OSA (19.4%), one study in pathology (1.3%), six on reconstruction (7.8%), none on temporomandibular joint disorders/facial pain (0%), 20 studies on trauma (25.9%), and 12 studies categorized as other (15.5%). CEAs made up 11.7% of studies and CMAs 58.4% of studies. Of the 9 CEAs, 55.6% were published after 2010. Of 45 CMAs, 88.6% were published since 2000 and 61.4% since 2010. CEAs met 56.0% (range 29.2 to 87.5%) of the CHEERS criteria while CMA studies met 45.1% (range 23.9 to 76.1%) of the modified CHEERS criteria. Only one study succeeded in estimating costs and health outcomes (value) of an OMS procedure.ConclusionThere is an increasing trend in the number of economic studies in the field of OMS. More high-quality economic evaluations are needed to demonstrate the value of OMS procedures. To determine value, future studies should both compare costs and health-related outcomes.



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