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牙周病诊断后早期牙齿缺失:临床决策模型的建立与验证。

Early Tooth Loss after Periodontal Diagnosis: Development and Validation of a Clinical Decision Model.

机构信息

Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz-Cooperativa de Ensino Superior, CRL, 2829-511 Almada, Portugal.

Department of Periodontology, CRU, CiiEM, Egas Moniz-Cooperativa de Ensino Superior, CRL, 2829-511 Almada, Portugal.

出版信息

Int J Environ Res Public Health. 2021 Feb 2;18(3):1363. doi: 10.3390/ijerph18031363.

Abstract

The aim of this study was to develop and validate a predictive early tooth loss multivariable model for periodontitis patients before periodontal treatment. A total of 544 patients seeking periodontal care at the university dental hospital were enrolled in the study. Teeth extracted after periodontal diagnosis and due to periodontal reasons were recorded. Clinical and sociodemographic variables were analyzed, considering the risk of short-term tooth loss. This study followed the transparent reporting of a multivariable prediction model for individual prognosis or diagnosis (TRIPOD) guidelines for development and validation, with two cohorts considered as follows: 455 patients in the development phase and 99 in the validation phase. As a result, it was possible to compute a predictive model based on tooth type and clinical attachment loss. The model explained 25.3% of the total variability and correctly ranked 98.9% of the cases. The final reduced model area under the curve (AUC) was 0.809 (95% confidence interval (95% CI): 0.629-0.989) for the validation sample and 0.920 (95% CI: 0.891-0.950) for the development cohort. The established model presented adequate prediction potential of early tooth loss due to periodontitis. This model may have clinical and epidemiologic relevance towards the prediction of tooth loss burden.

摘要

本研究旨在为牙周病患者在牙周治疗前开发和验证一种预测早期牙齿缺失的多变量模型。共有 544 名在大学牙科医院寻求牙周治疗的患者被纳入研究。记录了在牙周诊断后因牙周原因而拔除的牙齿。分析了临床和社会人口统计学变量,考虑了短期牙齿缺失的风险。本研究遵循透明报告多变量预测模型个体预后或诊断(TRIPOD)指南进行开发和验证,考虑了以下两个队列:455 名患者用于开发阶段,99 名患者用于验证阶段。结果,我们能够基于牙齿类型和临床附着丧失来计算预测模型。该模型解释了总变异性的 25.3%,正确地对 98.9%的病例进行了排名。验证样本的最终简化模型曲线下面积(AUC)为 0.809(95%置信区间(95%CI):0.629-0.989),而开发队列的 AUC 为 0.920(95%CI:0.891-0.950)。该模型对牙周病导致的早期牙齿缺失具有较好的预测潜力。该模型可能对预测牙齿缺失负担具有临床和流行病学意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1f49/7908103/8d5e35a56e02/ijerph-18-01363-g001.jpg

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