H Nekouei Amir, Mirzaee Moghaddameh, Shahravan Arash, Kakooei Shahla, Hasheminejad Naimeh
Faculty of Public Health, Department of Biostatistics and Epidemiology, Kerman University of Medical Sciences, Kerman, Iran.
Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
Med J Islam Repub Iran. 2023 Jul 10;37:77. doi: 10.47176/mjiri.37.77. eCollection 2023.
Dentures, both partial and complete, have been shown to have the same impact on one's quality of life. Due to the impossibility of randomization in these studies, they are prone to selection bias. This study aimed to compare the effect of partial and complete dentures on oral health-related quality of life (OHRQoL) by propensity score to overcome selection bias.
This is a cross-sectional descriptive-analytic study. A total of 1376 people participated in this study. Age, sex, marital status, education level, smoking, smoking opium and its derivatives, and dental visit was collected by a checklist. OHRQoL was measured by the OHIP-14 questionnaire. The generalized boosted model was used to estimate the propensity score. Missing data were imputed using multiple imputations with mixed models. The assumptions of multivariable regression analysis and propensity score method were first examined, and then the quality of life related to oral health was compared between the two groups.
The regression model's assumptions were not verified due to high skewness and collinearity. The results of the normality test ( < 0.001) and goodness fit test ( < 0.001) revealed that the regression model did not fit the data. The propensity score method reduced at least 76% of the bias resulting from the distribution difference between the confounding variables and was used for analysis. In the regression and propensity score method, the results showed that the total OHIP-14 score of the complete prosthesis group was higher than the partial prosthesis group at 3.92 (95% CI = (2.18,5.65)) and 3.64 (95% CI = (1.93,4.53)), respectively. This difference was clinically and statistically significant ( < 0.001). In addition, there is a significant difference in the two groups based on propensity in all seven areas ( < 0.001). But there is no significant difference in the regression adjustment of the Functional limitation of the two groups ( = 0.035).
The propensity score has fewer assumptions than the regression method and may be more reliable for OHIP scores. The propensity score analysis revealed that despite the costs and repair issues associated with partial dentures, complete denture wearers have lower OHRQoL than partial denture wearers.
部分义齿和全口义齿已被证明对人的生活质量有相同的影响。由于这些研究中不可能进行随机分组，它们容易出现选择偏倚。本研究旨在通过倾向评分比较部分义齿和全口义齿对口腔健康相关生活质量（OHRQoL）的影响，以克服选择偏倚。
这是一项横断面描述性分析研究。共有1376人参与了本研究。通过一份清单收集年龄、性别、婚姻状况、教育水平、吸烟、吸食鸦片及其衍生物以及看牙情况等信息。使用OHIP - 14问卷测量OHRQoL。采用广义增强模型估计倾向评分。使用混合模型的多重插补法对缺失数据进行插补。首先检验多变量回归分析和倾向评分法的假设，然后比较两组之间的口腔健康相关生活质量。
由于高度偏态和共线性，回归模型的假设未得到验证。正态性检验（<0.001）和拟合优度检验（<0.001）的结果表明回归模型不适合该数据。倾向评分法至少减少了76%因混杂变量分布差异导致的偏倚，并用于分析。在回归和倾向评分法中，结果显示全口义齿组的OHIP - 14总分分别比部分义齿组高3.92（95%CI =（2.18，5.65））和3.64（95%CI =（1.93，4.53））。这种差异在临床和统计学上均具有显著性（<0.001）。此外，在所有七个领域中，两组基于倾向评分存在显著差异（<0.001）。但两组在功能受限的回归调整方面无显著差异（P = 0.035）。
倾向评分比回归方法的假设更少，对于OHIP评分可能更可靠。倾向评分分析表明，尽管部分义齿存在成本和修复问题，但全口义齿佩戴者的OHRQoL低于部分义齿佩戴者。
