Elphinstone Scholarship - Valuing the benefits of oral health interventions for use in economic evaluation

Economic evaluations provide crucial information to different stakeholders including policymakers to ensure efficient resource allocation. Decision-making bodies provide guidance and recommendations on the reimbursement of new and existing interventions within healthcare systems based on clinical and cost-effectiveness evidence. Cost-effectiveness analyses in health typically use generic preference-based measures (PBM), such as EQ-5D or SF-6D, to calculate quality adjusted life year (QALY) to measure the benefits of treatments. Whilst these measures work well in most clinical contexts, they may not adequately capture oral health related quality of life (OHRQoL). Generic measures of health might not be sufficiently sensitive to capture the outcomes of care that are of greatest value to dental patients as they do not cover all relevant dimensions specific to dental care. Several validated OHRQoL instruments exist, however none of them are preference-based, meaning that they are not amenable for use in health economic evaluation. Hence, health economic evaluations in oral health research often use direct valuation methods such as willingness to pay (WTP), or a generic PBM such as EQ-5D.

Despite these concerns, little research has been conducted to measure the benefits of dental health interventions, or to determine appropriate health state utility values, for use in health economics evaluations, particularly in adult dental care. There are several research questions that can be addressed in this PhD: 

• Should a dental specific QALY be developed, and would existing oral health related quality of life (OHRQoL) measures such as the OHIP-14 be suitable for this? If so, the PhD could develop a preference-based measure of OHRQoL and generate valuation tariffs using surveys to enable calculation of dental QALYs.

• How do we best value acute dental health states (for example, tooth ache due to caries) that are short in duration?

• Should we generate societal willingness to pay tariffs for important dental health outcomes that could improve the interpretation of cost-effectiveness analyses or could inform development of cost-benefit analyses.

As part of the project, you will utilise data collected alongside existing and ongoing randomised controlled trials of interventions in adult primary dental care, including decision models, to implement and test the valuation approaches you develop. This will include investigating the impact of the methods you develop on the results of existing economic evaluation studies. Throughout the project, you will be encouraged to identify and develop your own methodological research questions to improve the valuation approaches.

APPLICATION PROCEDURE:

Formal applications can be completed online: https://www.abdn.ac.uk/pgap/login.php. You should apply for Degree of Doctor of Philosophy in Medical Sciences, to ensure that your application is passed to the correct person for processing.

NOTE CLEARLY THE NAME OF THE SUPERVISOR AND EXACT PROJECT TITLE ON THE APPLICATION FORM.