Dietrich Thomas, Kaiser Walter, Naumann Michael, Stosch Ulrike, Schwahn Christian, Biffar Reiner, Dietrich Dieter, Kocher Thomas
Department of Oral Surgery, The School of Dentistry, College of Medical and Dental Sciences, University of Birmingham, St. Chad's Queensway, Birmingham B4 6NN, UK.
J Clin Periodontol. 2009 Jun;36(6):493-7. doi: 10.1111/j.1600-051X.2009.01400.x.
Validation of a previously derived prediction rule for periodontitis in an external population sample.
Age, smoking and self-reported tooth mobility were used in logistic models to predict moderate and severe periodontitis as diagnosed from panoramic radiographs of 246 patients attending private practices in Germany. Coefficients derived from these models were used to predict periodontitis in a representative population-based sample of 3297 residents of the region of Pomerania, Germany.
In the full derivation sample, the predictive power of the logistic model as measured by the c-statistic was 0.82 and 0.84 for moderate and severe periodontitis, respectively. In the validation set, these models yielded c-statistics of 0.82 for both moderate and severe periodontitis. Lower c-statistics were obtained among subjects aged 40 years and older in the derivation set (c=0.74 and 0.77), and the performance was poorer in the validation set with c-statistics of 0.69 and 0.72, respectively.
A prediction rule based on age, smoking and self-reported tooth mobility can yield a moderately useful external validity. Validity may be dependent on specific population characteristics, and derivation of a prediction rule based on a clinical subsample of the target population with a larger set of predictors may provide better results in an application.
在外部人群样本中验证先前推导的牙周炎预测规则。
在逻辑模型中使用年龄、吸烟情况和自我报告的牙齿松动度来预测中度和重度牙周炎,这些牙周炎是根据德国私人诊所246名患者的全景X线片诊断得出的。从这些模型得出的系数用于预测德国波美拉尼亚地区3297名居民的具有代表性的基于人群的样本中的牙周炎情况。
在完整的推导样本中,逻辑模型预测中度和重度牙周炎的c统计量所衡量的预测能力分别为0.82和0.84。在验证集中,这些模型对中度和重度牙周炎得出的c统计量均为0.82。在推导集中40岁及以上的受试者中获得的c统计量较低(c = 0.74和0.77),在验证集中表现更差,c统计量分别为0.69和0.72。
基于年龄、吸烟情况和自我报告的牙齿松动度的预测规则可产生一定程度的外部有效性。有效性可能取决于特定的人群特征,并且基于目标人群的临床子样本并使用更多预测指标推导预测规则可能在应用中提供更好的结果。