Multivariate CART for survival with dental applicaions

点击翻译按钮获取中文摘要

Tooth loss from periodontal disease or dental caries afflicts most adults over the course of their lives. Goals of professional dental treatment and of personal oral health self-care are to prevent tooth loss and maintain the natural dentition in a state of comfort and function. In order to develop appropriate dental treatment planning, dental health care professionals must weigh the long-term outlook for retention of each tooth against the cost and discomfort involved with each treatment option, and patients and third-party payers must make value judgments about the cost of suggested dental treatments against the probability of long-term success for those treatments Hence, it is essential to utilize dental prognosis in the development of any dental treatment plan. Goals: The primary goals of this study are to further develop multivariate CART for survival and apply this newly extended form of CART for survival to a large, well-established database in an effort to develop global dental prognostic indicators that are based on actual tooth loss. Subjects: This hypothesis will be tested on up to 1231 dentate men who were enrolled in the Dental Longitudinal Study component of the VA Normative Aging Study, an established cohort of men followed for up to 30 years with triennial oral and medical examinations. Note that these men are not VA patients, and all subjects receive dental and medical care from a variety of practitioners in the private sector. Available historical data: Data for tooth loss, clinical restorative measures, clinical periodontal indices, medical status, smoking, alcohol, behavioral, and other parameters have been collected triennally over 30 years. Change in alveolar bone loss at all interproximal sites has also been measured from at least 6 sequential sets of full-mouth films per subject spanning a minimum of 15 years, which have been digitized with a computer-assisted image transformation technique. Measures of percent remaining bone and mean rates of alveolar bone loss are also available. Significance: Development of multivariate CART for survival can be applied to other dental data, and results of this study will provide objective criteria for assignment of global dental prognostic indicators that is based on actual tooth loss.