Department of Conservative Dentistry, Translational Health Economics Group (THE Group), Heidelberg University, Heidelberg, Germany.
Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Gerodontology. 2019 Jun;36(2):171-179. doi: 10.1111/ger.12398. Epub 2019 Mar 1.
To assess the validity of patient self-reported oral health measures as used in a large multi-country survey for populations aged 50+.
Information on people's oral health status is important for assessing oral health needs within populations. However, clinical examination is not always possible. Patient self-reported measures may provide an alternative when time and other resources are scarce.
Using oral health items from the Survey of Health, Ageing and Retirement in Europe (SHARE), self-reported measures were collected from 186 patients receiving treatment at Heidelberg University Hospital. Self-reports were compared with subsequent clinical examinations. Analyses were conducted for patients of all age groups and separately for patients aged 50+ (analogous to the SHARE study population). Diagnostic accuracy, agreement and correlation of patient-reported information were examined using descriptive statistics and Bland-Altman plots.
Patient-reported presence or absence of a full tooth count was closely related to clinical measurement, both for all age groups (sensitivity: 93%; specificity: 92%) and persons aged 50+ (sensitivity: 100% specificity: 94%). Bland-Altman plots indicate good agreement between patient- and clinical reports of the number of teeth at age 50+ (Concordance Correlation Coefficient = 0.95). Discriminatory power of patient-reporting was good regarding presence vs absence of artificial teeth, but less robust regarding partial vs full replacement of missing teeth.
Patient self-evaluations provide reasonable estimates of clinical measures and appear sufficiently accurate for examining variations in the number of teeth, including among populations aged 50+. However, patient reports of the extent of replacement of missing teeth may not constitute reliable reflections of clinical conditions.
评估在一项针对 50 岁以上人群的大型多国家调查中使用的患者自我报告口腔健康测量的有效性。
了解人们的口腔健康状况对于评估人群中的口腔健康需求非常重要。然而，临床检查并不总是可行的。当时间和其他资源有限时，患者自我报告的测量方法可能是一种替代方法。
使用欧洲健康、老龄化和退休调查（SHARE）中的口腔健康项目，从海德堡大学医院接受治疗的 186 名患者中收集了自我报告的测量值。将自我报告与随后的临床检查进行比较。对所有年龄组的患者进行了分析，并分别对 50 岁以上的患者（类似于 SHARE 研究人群）进行了分析。使用描述性统计和 Bland-Altman 图检查了患者报告信息的诊断准确性、一致性和相关性。
患者报告的全牙计数的存在或缺失与临床测量结果密切相关，无论是在所有年龄组（敏感性：93%；特异性：92%）还是在 50 岁以上的人群中（敏感性：100%；特异性：94%）。Bland-Altman 图表明，50 岁以上患者的自我报告和临床报告的牙齿数量之间存在良好的一致性（一致性相关系数=0.95）。患者报告在人工牙齿的存在与缺失方面具有良好的判别能力，但在缺失牙齿的部分与完全替换方面的稳健性较差。
患者自我评估提供了对临床测量的合理估计，并且在检查牙齿数量的变化方面似乎足够准确，包括在 50 岁以上的人群中。然而，患者对缺失牙齿替换程度的报告可能无法可靠反映临床情况。
