Pitiphat Waranuch, Garcia Raul I, Douglass Chester W, Joshipura Kaumudi J
Harvard School of Dental Medicine, Harvard School of Public Health, 188 Longwood Avenue, Boston, MA 02115, USA.
J Public Health Dent. 2002 Spring;62(2):122-8. doi: 10.1111/j.1752-7325.2002.tb03432.x.
To assess the validity of self-reported oral disease and health care measures in two populations.
Telephone interviews were conducted among a subsample of participants in the VA Dental Longitudinal Study (VADLS) asking them about periodontal disease status and treatment. Radiographic alveolar bone loss evaluated at all the interproximal sites was used as the standard. A separate study was carried out among first-time patients at the Harvard School of Dental Medicine (HSDM) student clinic. Self-reported measures were obtained by a self-administered questionnaire and compared with clinical and radiograph examinations. The measures used were based on published work that demonstrated good validity of self-reported periodontal measures among health professionals.
Among 145 VADLS participants, self-reports of periodontal disease showed a good specificity (59.8%-90.7%), but low sensitivity (17.7%-64.7%). Among 58 HSDM patients, the self-reported numbers of remaining teeth, fillings, root canal therapy, and prosthesis were strongly correlated with clinical records (r = 0.74-1.0); self-report was less accurate for measures of periodontal disease (r = 0.56) and decayed teeth (r = 0.47).
Self-reports provide reasonably valid estimates for numbers of remaining teeth, fillings, root canal therapy, and fixed and removable prostheses. However, they appear to be less useful for the assessment of dental caries and periodontal disease in the two populations we have studied. There remains a need and potential to further develop self-report oral health measures that are valid for use in large population studies. Such self-report measures would yield great cost and time savings.
评估在两个人群中自我报告的口腔疾病和医疗保健措施的有效性。
对退伍军人事务部牙科纵向研究(VADLS)的部分参与者进行电话访谈,询问他们的牙周疾病状况和治疗情况。以在所有邻面部位评估的放射学牙槽骨丧失情况作为标准。在哈佛牙医学院(HSDM)学生诊所对初诊患者开展了另一项研究。通过自行填写问卷获取自我报告的测量数据,并与临床检查和影像学检查结果进行比较。所使用的测量方法基于已发表的研究成果,这些研究表明自我报告的牙周测量指标在卫生专业人员中具有良好的有效性。
在145名VADLS参与者中,牙周疾病的自我报告显示出较高的特异性(59.8%-90.7%),但敏感性较低(17.7%-64.7%)。在58名HSDM患者中,自我报告的剩余牙齿数量、补牙情况、根管治疗情况和修复体与临床记录高度相关(r = 0.74-1.0);对于牙周疾病(r = 0.56)和龋齿(r = 0.47)的测量,自我报告的准确性较低。
自我报告对于剩余牙齿数量、补牙情况、根管治疗以及固定和活动修复体的数量能提供合理有效的估计。然而,在我们所研究的两个人群中,自我报告对于龋齿和牙周疾病的评估似乎用处较小。仍有必要且有潜力进一步开发适用于大规模人群研究的有效自我报告口腔健康测量方法。此类自我报告测量方法将节省大量成本和时间。