Patient and clinician perspectives on implant dentistry decision aid content: Results from an enhanced Delphi study.

Abstract

To investigate patient and clinician perspectives on what is considered important to include in a decision aid for replacement of a missing tooth with an implant. An online modified Delphi method with pair comparisons technique was used to survey participants (66 patients, 48 prosthodontists, 46 periodontists, and 31 oral surgeons) in Ontario, Canada from November 2020 to April 2021 regarding the importance of information provided during an implant consultation. Round one included 19 items derived from the literature and informed consent protocols. The decision to retain an item was based on group consensus, defined as at least 75% of participants identifying the item as "important" or "highly important." After analysis of round one results, a second-round survey was sent to all participants to rank the relative importance of the consensus items. Statistical testing was completed using the Kruskal-Wallis one-way analysis of variance test and post hoc Mann-Whitney U tests with a significance level set at p≤0.05. The first and second surveys had response rates of 77.0% and 45.6%, respectively. In round one, all items except purpose of steps reached group consensus. In round two, the highest group ranked items were patient responsibilities for treatment success and follow-ups after treatment. The lowest group ranked items were cost factors and restorative steps. Significant differences between the stakeholder groups were found on several items, including diagnosis (p≤0.00), non-implant options (p≤0.00), and cost (p≤0.01). In general, patients' opinions were significantly different than clinicians' opinions on the relative importance of items. Clinicians and patients feel that multiple items are important to include in a decision aid for implant therapy; however, differences exist between patients and clinicians on the relative importance of items.