Department of Dental Public Health and Policy, Virginia Commonwealth University, School of Dentistry, Richmond, VA, USA.
Institute for Inquiry, Innovation and Inclusion, Virginia Commonwealth University, Richmond, VA, USA.
J Public Health Dent. 2020 Sep;80(4):259-270. doi: 10.1111/jphd.12376. Epub 2020 Jul 13.
To evaluate the performance of subjective self-assessment of dental care need with objective oral disease status in a sample of Hispanics/Latinos.
Data from 13,561 participants of the 2008-2011 Hispanic Community Health Study/Study of Latinos were analyzed using complex survey procedure in SAS 9.4. Subjective self-reports of types of dental care needed (check-up or cleaning, teeth filled, teeth pulled, gum treatment, denture repair) were validated against objectively determined oral disease status [dental decay, periodontitis, bleeding on probing (BOP) and count of missing teeth].
Individuals who reported needing a cleaning/checkup were twice as likely to present with BOP upon oral examination (POR = 2.01, 95% CI: 1.54, 2.63). Similarly, individuals who reported needing gum treatment were more likely to present with periodontitis (POR = 1.96, 95% CI: 1.71, 2.24) and BOP (POR = 2.70, 95% CI: 2.37, 3.07) upon oral examination. In multivariable prediction modeling, demographic factors and subjective dental care measures were associated with the respective oral disease states. Moreover, the sensitivity, specificity, and area under the ROC curve for the count of missing teeth were, respectively, 77 percent, 57 percent, and 0.84, while the positive predictive value (PPV) was 26 percent.
In bivariate analysis, self-reported type of dental care needed appear indicative of actual oral disease state and may be of value for the surveillance of oral diseases when clinical measures are unattainable. In multivariable prediction modeling, these subjective measures had low PPVs thus limiting the generalizability of our findings. Nonetheless, validation and refinement of these constructs in other populations is warranted.
评估主观自我评估的牙科护理需求与西班牙裔/拉丁裔样本中客观口腔疾病状况的表现。
使用 SAS 9.4 中的复杂调查程序对 2008-2011 年西班牙裔社区健康研究/拉丁裔研究的 13561 名参与者的数据进行了分析。主观报告的需要的牙科护理类型（检查或清洁、补牙、拔牙、牙龈治疗、义齿修复）与客观确定的口腔疾病状况（龋齿、牙周炎、探诊出血（BOP）和缺牙数）进行了验证。
报告需要清洁/检查的个体在口腔检查时出现 BOP 的可能性是报告者的两倍（POR = 2.01，95%CI：1.54，2.63）。同样，报告需要牙龈治疗的个体更有可能出现牙周炎（POR = 1.96，95%CI：1.71，2.24）和 BOP（POR = 2.70，95%CI：2.37，3.07）。在多变量预测模型中，人口统计学因素和主观牙科护理措施与相应的口腔疾病状态相关。此外，缺牙数的灵敏度、特异性和 ROC 曲线下面积分别为 77%、57%和 0.84，阳性预测值（PPV）为 26%。
在双变量分析中，自我报告的牙科护理需求类型似乎表明实际的口腔疾病状态，并且在临床措施无法获得时，可能对口腔疾病的监测具有价值。在多变量预测模型中，这些主观措施的 PPV 较低，因此限制了我们研究结果的普遍性。尽管如此，仍需要在其他人群中验证和改进这些结构。
