There is limited evidence to support optimal patient-centered management for compromised first permanent molars (cFPM) in children. Based on an online discrete choice experiment (DCE), this study elicits UK adult general population preferences and calculates willingness to pay (WTP) for pathways to manage cFPM. The DCE was designed with information from semistructured interviews and literature reviews, as well as focus groups with an expert panel of dentists, citizens, and policy makers. A statistically optimal D-efficient design generated 18 choice tasks, split across 2 blocks. Each respondent answered one block of 9 tasks to reduce survey fatigue. Choice tasks varied across 5 attributes: type of treatment, provider of care, who makes the management decision, number of future visits avoided, and cost. An opt-out was included (no treatment). Conditional logit models (fixed effects) were used for data analysis, and marginal WTP for each attribute level was calculated. An overall 430 respondents completed the DCE. Respondents valued children receiving care as compared with not. Restoring a cFPM was valued equally to spontaneous or orthodontic gap closure. In contrast, having a partial gap, prosthetic replacement with a bridge, or a full unit gap was valued less than restoration or full gap closure. General dentists were preferred to dentists with enhanced skills, but there was no evidence of a preference for general dentists over specialists in pediatric dentistry. Respondents preferred to be wholly or partly involved in the decision-making process as opposed to the dentist making the decision alone. Respondents preferred less costly treatments and the avoidance of future dental work. Dental care service providers must consider service user preferences for health and nonhealth outcomes in any service redesign. Furthermore, the results provide marginal WTP estimates that can be used to value dental care services.

中文翻译：

---

管理受损磨牙的公共估值：离散选择实验


有限的证据支持对儿童受损的第一恒磨牙 （cFPM） 进行以患者为中心的最佳管理。基于在线离散选择实验 （DCE），本研究得出了英国成年人的一般人群偏好，并计算了管理 cFPM 的途径的支付意愿 （WTP）。DCE 的设计信息来自半结构化访谈和文献综述，以及与牙医、公民和政策制定者组成的专家小组的焦点小组。统计最优的 D 效率设计生成了 18 个选择任务，分为 2 个模块。每个受访者都回答了 9 项任务中的一个模块，以减少调查疲劳。选择任务在 5 个属性上有所不同：治疗类型、护理提供者、谁做出管理决策、避免的未来就诊次数和成本。包括选择退出 （无治疗）。使用条件 logit 模型 （固定效应） 进行数据分析，并计算每个属性级别的边际 WTP。共有 430 名受访者完成了 DCE。与不接受照顾的儿童相比，受访者更重视接受照顾的儿童。恢复 cFPM 与自发性或正畸间隙闭合同等重要。相比之下，具有部分间隙、用牙桥替换修复体或完全单位间隙的价值低于修复或完全间隙闭合。普通牙医优于技能增强的牙医，但没有证据表明普通牙医优于儿科牙科专家。受访者更愿意全部或部分参与决策过程，而不是牙医单独做出决定。受访者更喜欢成本较低的治疗和避免未来的牙科工作。 牙科护理服务提供商在任何服务重新设计中都必须考虑服务用户对健康和非健康结果的偏好。此外，结果提供了可用于评估牙科护理服务的边际 WTP 估计值。