个人自我报告口腔健康措施在因果研究应用中评估牙周炎的有效性。

IF 4.2 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Journal of periodontology Pub Date : 2024-01-10 DOI:10.1002/JPER.23-0551
Julia C. Bond, Sharon M. Casey, Robert McDonough, Suzanne G. McLone, Mabeline Velez, Brenda Heaton
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引用次数: 0

摘要

背景:用于人口监测的牙周炎自我报告测量方法越来越多地用于因果关系研究。许多研究根据牙周炎的临床参数对这些测量方法的有效性进行了评估,但很少有研究包括多变量模型之外的验证参数。在因果关系研究中使用这些测量方法时,必须充分考虑单个项目的有效性:我们使用了 2011-2014 年全国健康与营养调查的数据,其中有牙齿的参与者完成了全口牙周检查(N = 6966)。我们对照美国疾病控制与预防中心和美国牙周病学会(CDC-AAP)制定的牙周炎病例定义,评估了与牙周病状况相关的六个自我报告问卷项目。我们使用重度和中重度牙周炎分类估算了各个项目的敏感性和特异性。此外,我们还合并了一些项目,以评估联合测量的有效性:结果:针对重度牙周炎进行评估时,灵敏度最高。自评口腔健康状况为一般/较差时,对重度牙周炎(0.60)和中重度牙周炎(0.48)的敏感性最高。在评估中重度牙周炎时,特异性最高,自我报告的牙齿移动史是最具特异性的指标(重度牙周炎为 0.87;中重度牙周炎为 0.92),其次是骨质流失史(重度牙周炎为 0.88;中重度牙周炎为 0.91)。合并问题通常会提高特异性,但会降低灵敏度:我们在项目特异性有效性和相关临床特征方面的发现有助于在因果关系研究中使用自我报告的牙周炎测量方法时进行必要的考虑。此外,项目特异性有效性还可用于评估此类调查中的分类偏差。
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Validity of individual self-report oral health measures in assessing periodontitis for causal research applications

Background

Self-reported measures of periodontitis developed for use in population surveillance are increasingly used in causal research. Numerous studies evaluate the validity of these measures against clinical parameters of periodontitis, yet few include validation parameters outside of multivariable models. Individual item validity is necessary to adequately inform use of these measures in causal research.

Methods

We used data from the National Health and Nutrition Examination Survey 2011-2014 in which dentate participants completed full-mouth periodontal examinations (N = 6966). We evaluated six self-report questionnaire items related to periodontal disease status against periodontitis case definitions developed by the Centers for Disease Control and Prevention and American Academy of Periodontology (CDC-AAP). We estimated the sensitivity and specificity of individual items using severe and moderate-to-severe periodontitis classifications. We additionally combined items to evaluate the validity of joint measures.

Results

Sensitivity was highest when measures were evaluated against severe periodontitis. Self-rated oral health of fair/poor demonstrated the highest sensitivity for severe (0.60) and moderate-to-severe periodontitis (0.48). Specificity was highest when evaluated against moderate-to-severe periodontitis, with self-reported history of tooth mobility as the most specific measure (0.87 for severe disease; 0.92 for moderate-to-severe) followed by a history of bone loss (0.88 for severe; 0.91 for moderate-to-severe). Combining questions generally improved specificity at the expense of sensitivity.

Conclusions

Our findings related to item-specific validity and the associated clinical profiles facilitate needed considerations for the use of self-reported measures of periodontitis in causal research. Additionally, item-specific validity can be used to inform assessments of misclassification bias within such investigations.

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来源期刊
Journal of periodontology
Journal of periodontology 医学-牙科与口腔外科
CiteScore
9.10
自引率
7.00%
发文量
290
审稿时长
3-8 weeks
期刊介绍: The Journal of Periodontology publishes articles relevant to the science and practice of periodontics and related areas.
期刊最新文献
Periodontitis associated with brain function impairment in middle-aged and elderly individuals with normal cognition. Artificial intelligence with counseling on the treatment outcomes and quality of life in periodontitis patients. Impact of nonsurgical periodontal treatment on arterial stiffness outcomes related to endothelial dysfunction: A systematic review and meta-analysis. Appraising the life-course impact of Epstein-Barr virus exposure and its genetic signature on periodontitis. Effectiveness of nonsurgical re‐instrumentation: Tooth‐related factors
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