Dental Informatics Core, Department of Cariology, Operative Dentistry & Dental Public Health, Indiana University School of Dentistry, IUPUI, Indianapolis, Indiana, United States.
Center for Biomedical Informatics, Regenstrief Institute, Inc., Indianapolis, Indiana, United States.
Appl Clin Inform. 2020 Mar;11(2):305-314. doi: 10.1055/s-0040-1709506. Epub 2020 Apr 29.
The aim of this study is to determine the feasibility of conducting clinical research using electronic dental record (EDR) data from U.S. solo and small-group general dental practices in the National Dental Practice-Based Research Network (network) and evaluate the data completeness and correctness before performing survival analyses of root canal treatment (RCT) and posterior composite restorations (PCR).
Ninety-nine network general dentistry practices that used Dentrix or EagleSoft EDR shared de-identified data of patients who received PCR and/or RCT on permanent teeth through October 31, 2015. We evaluated the data completeness and correctness, summarized practice, and patient characteristics and summarized the two treatments by tooth type and arch location.
Eighty-two percent of practitioners were male, with a mean age of 49 and 22.4 years of clinical experience. The final dataset comprised 217,887 patients and 11,289,594 observations, with the observation period ranging from 0 to 37 years. Most patients (73%) were 18 to 64 years old; 56% were female. The data were nearly 100% complete. Eight percent of observations had incorrect data, such as incorrect tooth number or surface, primary teeth, supernumerary teeth, and tooth ranges, indicating multitooth procedures instead of PCR or RCT. Seventy-three percent of patients had dental insurance information; 27% lacked any insurance information. While gender was documented for all patients, race/ethnicity was missing in the dataset.
This study established the feasibility of using EDR data integrated from multiple distinct solo and small-group network practices for longitudinal studies to assess treatment outcomes. The results laid the groundwork for a learning health system that enables practitioners to learn about their patients' outcomes by using data from their own practice.
本研究旨在确定在美国独立或小型牙科诊所的国家牙科实践为基础的研究网络(网络)中使用电子牙科记录(EDR)数据进行临床研究的可行性,并在进行根管治疗(RCT)和后牙复合树脂修复(PCR)生存分析之前评估数据的完整性和正确性。
99 家使用 Dentrix 或 EagleSoft EDR 的网络普通牙科诊所通过 2015 年 10 月 31 日共享了接受 PCR 和/或 RCT 的永久牙齿的患者的去识别数据。我们评估了数据的完整性和正确性,总结了实践和患者特征,并按牙位和牙弓位置总结了两种治疗方法。
82%的从业者为男性,平均年龄为 49 岁,临床经验为 22.4 年。最终数据集包括 217887 名患者和 11289594 次观察,观察期从 0 到 37 年不等。大多数患者(73%)年龄在 18 至 64 岁之间;56%为女性。数据几乎 100%完整。8%的观察结果数据不正确,如不正确的牙位或牙面、乳牙、多生牙和牙位范围,表明多牙治疗而非 PCR 或 RCT。73%的患者有牙齿保险信息;27%的患者没有任何保险信息。虽然所有患者都记录了性别,但数据集缺失种族/民族信息。
本研究证实了从多个不同的独立或小型网络实践中整合 EDR 数据进行纵向研究以评估治疗结果的可行性。研究结果为学习健康系统奠定了基础,使从业者能够通过使用自己实践中的数据了解患者的治疗效果。