Peer Assessment Rating (PAR) scoring of cleft patients treated within a regional cleft centre in the United Kingdom

Objective: To assess static occlusal outcomes for patients with cleft lip and/or palate (CLP) and cleft palate (CP) managed within a UK Regional Cleft Service and to compare with previously published Peer Assessment Rating (PAR) scores from a non-cleft population of patients treated within a UK consultant-led hospital service. Design: Retrospective multicentre study. Setting: Eight orthodontic hospital units within the Spires Cleft Service, UK. Participants: Patients born with CLP or CP between 1985 and 1995 treated within the service. Methods: Patients were assigned to groups by cleft type and whether they were treated by orthodontics only or a combination of orthodontics and orthognathic surgery. PAR was recorded before and after treatment from study models. Results: Data were collected for 171 patients included in the study. Median pre-treatment PAR was 42 and post-treatment 11. Median percentage change in PAR for all patients was 73%, although 12% of cleft patients had a PAR improvement that was worse or no different. Median change in PAR score was 71% for those treated with orthodontics only and 83% for those who had an osteotomy. Median PAR improvement for those treated with orthodontics only was 73% in the cleft lip group, 77% in the CP group, 66% in the unilateral CLP group and 53% in the bilateral CLP group. Median pre- and post-treatment PAR for the cleft group was higher and PAR reduction lower than those published for non-cleft patients. Conclusion: These data demonstrate high severity of malocclusion, complexity of orthodontic treatment and difficulty in achieving an ideal static occlusion for cleft patients. If PAR is to be used to assess orthodontic outcomes in cleft patients the findings of this study should be considered. A higher proportion of cases are likely to be classed as ‘worse or no different’, and a lower percentage change will be expected.

Validity and Reproducibility of the Peer Assessment Rating Index Scored on Digital Models Using a Software Compared with Traditional Manual Scoring

The aim of this study was to assess the validity and reproducibility of digital scoring of the Peer Assessment Rating (PAR) index and its components using a software, compared with conventional manual scoring on printed model equivalents. The PAR index was scored on 15 cases at pre- and post-treatment stages by two operators using two methods: first, digitally, on direct digital models using Ortho Analyzer software; and second, manually, on printed model equivalents using a digital caliper. All measurements were repeated at a one-week interval. Paired sample t-tests were used to compare PAR scores and its components between both methods and raters. Intra-class correlation coefficients (ICC) were used to compute intra- and inter-rater reproducibility. The error of the method was calculated. The agreement between both methods was analyzed using Bland-Altman plots. There were no significant differences in the mean PAR scores between both methods and both raters. ICC for intra- and inter-rater reproducibility was excellent (≥0.95). All error-of-the-method values were smaller than the associated minimum standard deviation. Bland-Altman plots confirmed the validity of the measurements. PAR scoring on digital models showed excellent validity and reproducibility compared with manual scoring on printed model equivalents by means of a digital caliper.

Orthodontic Treatment and Healthcare Goals: Evaluation of Multibrackets Treatment Results Using PAR Index (Peer Assessment Rating)

Background: The evaluation of orthodontic treatment outcomes using an objective method is important in order to maintain high treatment quality and final healthcare of patients. It allows professionals and university students to raise the level of the therapy. The aim of this study was to assess the orthodontic treatment outcomes in an Italian postgraduate School of Orthodontics using Peer Assessment Rating (PAR) Index. Methods: A sample of 50 patients treated in a postgraduate program was randomly selected. PAR index was used to assess pre-treatment and post-treatment study casts by two different examiners. The influence of different variables such as gender, treatment method, and need for extraction was statistically analyzed. Results: The average numerical reduction of PAR between the beginning and the end of the treatment was 18.74 (CI 95% 16.53–20.95), while the percentage reduction was 94.8% (CI 95% 91.91–97.68). All cases improved: 8% of patients resulted in the improved category, while 92% of them were in the greatly improved group. Conclusions: According to PAR index, the results showed that patients received a high-standard therapy. None of the factors studied influenced significantly the treatment outcomes.

Penilaian Tingkat Keberhasilan Perawatan Ortodontik dengan Piranti Lepasan Berdasarkan Indeks PAR di RSGM Universitas Baiturrahmah Tahun 2012-2017

AbstrakPerawatan ortodontik dapat dilakukan dengan menggunakan ortodontik cekat maupun lepasan. Observasi dilapangan, perawatan ortodontik di bagian ortodonti RSGM Universitas Baiturrahmah menggunakan alat ortodontik lepasan. Selama ini belum pernah dilakukan evaluasi tingkat keberhasilan perawatan ortodontik terhadap pasien yang telah selesai dirawat yang diukur dengan Peer Assessment Rating Index (indeks PAR). Tujuan: Menentukan tingkat keberhasilan perawatan ortodontik dengan piranti lepasan di bagian ortodonti RSGM Universitas Baiturrahmah berdasarkan indeks PAR. Metode: Jenis penelitian ini adalah kuantitatif dengan metode observasional analitik serta menggunakan pendekatan waktu penelitian cross-sectional study. Penelitian ini dilakukan di bagian ortodonti RSGM Universitas Baiturrahmah pada bulan September sampai Oktober 2018. Sampel yang diambil yaitu model gigi pasien yang telah selesai menjalani perawatan ortodontik dari tahun 2012 sampai 2017 di bagian ortodonti RSGM Universitas Baiturrahmah yang memenuhi kriteria inklusi dan eksklusi. Dari 122 model gigi, didapatkan 46 sampel yang memenuhi kriteria inklusi. Hasil: Tingkat keberhasilan perawatan ortodonti lepasan di RSGM Universitas Baiturrahmah banyak yang “tidak mengalami perbaikan” (60,9%), namun secara statistik terjadi perbedaan skor yang signifikan sebelum dan sesudah perawatan. Simpulan: Masing-masing komponen indeks PAR secara deskriptif mengalami penurunan skor sebelum dan sesudah perawatan, namun secara statistik yang mengalami perbedaan skor signifikan hanya pada segmen anterior rahang atas dan bawah serta overjet.