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This page contains reports of the major research projects and publications Dr Daniels has been substantially involved in

Cost-effectiveness analysis of the three NHS orthodontic provider services in Wales, 1997-2001.  This was a UK national prospective investigation involving a team of 4 investigating orthodontists, a statistician, a health economist, and research assistants.  The project set out to comprehensively assess the orthodontic outcomes and related costs at the patient, practitioner and service level.  Dr Daniels role was to obtain clinical outcomes data, data verification and ‘cleaning’, and preliminary analysis, production of publications.

An analysis of the orthodontic case mix treated by the hospital, community and general dental services in Wales.  Formed the basis for the MScD dissertation  2000.  Findings from this thesis were presented at the scientific session papers for orthodontic trainees at the British Orthodontic conference 1999.

An international comparison of professional opinion in orthodontics. Ph.D  thesis 1998.  This project examined the complex factors that together determine an orthodontist’s decision to recommend treatment and determine his perception of acceptable treatment outcome.  The factors considered included practitioner related factors such as work intensity, remuneration system, perception of self worth and patient related factors such as malocclusion severity and actual outcome.  The analysis was based on the judgements of 97 orthodontists from 9 countries on a standard sample of patient records.  Dr Daniels developed the sample and documentation, managed the study day set ups, data quality control and statistical analysis.  Multiple logistic regression analysis was  used to formulate a model for the data and The ICON index was derived from the statistical model. The index is now being used as an audit tool in the UK and USA.

The EUROQUAL Project 1994-1996

This project was an international collaboration whose aims were to establish a quality assurance mechanism for orthodontics in Europe.  The steering group included, Professor Prahle- Andersen (Netherlands), Professor Rolf Berg (Germany), Professor Francesce Miotti (Italy), Professor Joannis Adamidis (Greece),  Professor Jose Canut (Spain), Professor Giselda Rehak (Hungary), Dr Stephen Richmond (UK).

This project provided the material for the Ph.D. thesis.

An investigation into potential differences in the outcome of orthodontic treatment in North Western and Mersey regions. 1996-1998

The findings from this project were published at the British Orthodontic Conference in Scarborough and two further publications resulted (see below).  Dr Daniels  was involved in the analysis of data and rewriting of papers.

Papers Published

S.Richmond, C.J.Philips, F.Dunstan, C.Daniels, P.Durning, F.Leahy Evaluating the cost-effectiveness of orthodontic provision. Dental Update 2002: 31:146-152.

Daniels C.  1999 Optident Prize and William Houston Medal of the Royal College of Surgeon of Edinburgh.  J. Orthodontics. 2001:28:1-12

Daniels CP and Richmond S.  The development of the index of complexity , outcome and need, (ICON). 2000 Journal of Orthodontics.  Vol 27:149-162

Fox N.A., Richmond S., Daniels C Wright J.  Factors affecting the outcome of orthodontic treatment in the General Dental Services. 1997 Br J Orth 24 (3):217-21

Richmond S., Daniels C. Fox N. Wright J.   The professional perception of orthodontic treatment complexity 1997 Br Dent J 183 (10): 371-5

Richmond S., Daniels C. International comparisons of professional assessments in orthodontics : Part 1  treatment need. 1998 Am J Ortho 113 (2) :180 -5

Richmond S., Daniels C. International comparisons of professional assessments in orthodontics : Part 2  treatment outcome. 1998 Am J Ortho 113 (3) :324 -8

Mc Knight M, Daniels CP, Johnston LE .  A retrospective study of two stage treatment outcomes assessed with two modified PAR indices.  1998 Angle Orthod 68 (6) :521-4

Lee RT, Crow V, Dixon J, Daniels C.  Assessment of clinical case presentations for the Membership in Orthodontics, Royal College of Surgeons of England 1995, 1996.  BJO 26 (1): 15-9, 1999

Fox N, Daniels C, Gilgrass T, A comparison of the  Index of Complexity, Outcome and Need (ICON), with the  Peer Assessment Rating (PAR) and The Index of Orthodontic Treatment Need (IOTN). BDJ  192:225-230. 2002


Daniels CP, Richmond S. The index of Complexity,  Outcome and Need (ICON). British Orthodontic Conference 1999.


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