{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T15:54:41Z","timestamp":1781538881463,"version":"3.54.5"},"reference-count":34,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2025,8,16]],"date-time":"2025-08-16T00:00:00Z","timestamp":1755302400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,8,16]],"date-time":"2025-08-16T00:00:00Z","timestamp":1755302400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["APP11211982"],"award-info":[{"award-number":["APP11211982"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["JDR Clinical &amp; Translational Research"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Early childhood caries is a significant problem affecting Aboriginal preschoolers in remote communities who lack access to dental services. A trial was conducted to assess the benefits of atraumatic restorative treatment combined with the Hall technique (ART-HT) versus usual care for managing early childhood caries in this population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>This trial-based cost-utility analysis evaluates costs and quality-adjusted life-years (QALYs) of ART-HT compared with usual care within a 1-y time frame.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A decision-analytic model simulated the costs and QALYs for 2 scenarios: trial service delivery and minimum ART-HT delivery. The incremental cost per QALY gain ratio (ICER) was calculated for each scenario. QALY were estimated using the Early Childhood Oral Health Impact Scale-4D (ECOHIS-4D) and adjusted for baseline. Probabilistic sensitivity analyses were conducted to assess the robustness of the base-case results. Cost-effectiveness acceptability curves were generated to determine the likelihood of ART-HT being cost-effective at various willingness-to-pay thresholds. All costs are presented in Australian dollars for 2021.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Children receiving ART-HT had slightly higher QALYs than those receiving usual care did (0.85 vs. 0.83). The base-case analysis showed an average ICER of $2,013\/QALY gained (95% uncertainty interval \u2212$45,246 to $21,676). In the sensitivity analysis, the average ICER was $2,573\/QALY gained (95% uncertainty interval \u2212$43,658 to $23,352). ART-HT had an 85% and 81% chance of being cost-effective at a $15,000\/QALY gained threshold in the base-case and alternative scenario, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>ART-HT showed potential cost-effectiveness compared with usual care within the observed period. While QALY gains were modest, ART-HT may offer a valuable strategy to improve service access for Aboriginal children in remote communities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Knowledge Transfer Statement:<\/jats:title>\n                    <jats:p>This study demonstrates that atraumatic restorative treatment combined with the Hall technique (ART-HT) is cost-effective in managing early childhood caries in remote Aboriginal communities. By providing a viable dental care strategy, ART-HT can improve access to essential dental services, enhance oral health outcomes for Aboriginal preschoolers, and offer value for money, thereby contributing to overall better health in these underserved populations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/23800844251346743","type":"journal-article","created":{"date-parts":[[2025,8,16]],"date-time":"2025-08-16T09:52:18Z","timestamp":1755337938000},"page":"368-376","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Cost-Utility Analysis of Treatments for Early Childhood Caries in Remote Aboriginal Communities"],"prefix":"10.1177","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6464-744X","authenticated-orcid":false,"given":"U.","family":"Tonmukayakul","sequence":"first","affiliation":[{"name":"Deakin Health Economics, Institute for Health Transformations, Deakin University, Geelong, VIC, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Kularatna","sequence":"additional","affiliation":[{"name":"Australian Centre for Health Services Innovation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia"},{"name":"Health Services and System Research, Duke-NUS Medical School, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Atkinson","sequence":"additional","affiliation":[{"name":"Rural Clinical School of Western Australia, University of Western Australia, Broome, Western Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Jamieson","sequence":"additional","affiliation":[{"name":"Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, SA, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1647-2128","authenticated-orcid":false,"given":"P.","family":"Arrow","sequence":"additional","affiliation":[{"name":"Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, SA, Australia"},{"name":"Western Australia Dental Health Services, Perth, WA, Australia"},{"name":"Dental School, University of Western Australia, Perth, WA, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,8,16]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-020-02646-8"},{"key":"e_1_3_3_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/adj.12749"},{"key":"e_1_3_3_4_1","doi-asserted-by":"crossref","unstructured":"Arrow P Forrest H Piggott S. 2021. Minimally invasive dentistry: parent\/carer perspectives on atraumatic restorative treatments and dental general anaesthesia to the management of early childhood caries. Front Oral Health. 2:656530. https:\/\/doi.org\/10.3389\/froh.2021.656530.","DOI":"10.3389\/froh.2021.656530"},{"key":"e_1_3_3_5_1","doi-asserted-by":"crossref","unstructured":"Arrow P McPhee R Atkinson D Mackean T Kularatna S Tonmukayakul U Brennan D Palmer D Nanda S Jamieson L. 2018. Minimally invasive dentistry based on atraumatic restorative treatment to manage early childhood caries in rural and remote Aboriginal communities: protocol for a randomized controlled trial. 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