Analysis of Restoration Longevity in Elderly Patients using Electronic Dental Rec

描述（由申请人提供）：患者、牙齿和修复体水平的因素如何影响老年患者群体中汞合金和复合修复体的寿命，这是一个重要的问题，因为目前全国都在讨论卫生保健的质量、成本和适当性。目前可获得的关于老年人恢复寿命的结果在几个方面受到限制（针对老年人的研究很少；大多数现有研究在美国以外进行，地理位置有限，通常是专门的人群；样本量小；数据源存在固有偏差）。该项目建议使用来自两个主要健康维护组织HealthPartners和Marshfield Clinic的电子牙科记录（EDR）数据来分析修复寿命。我们将在两个具体目标（SA）中这样做：(1)从虚拟数据仓库（VDW）生成研究数据集，用于使用基于本体的方法进行统计分析；(2)对数据集进行统计分析，确定影响老年人恢复寿命的因素。在SA 1中，我们将首先扩展匹兹堡大学和布法罗大学合作开发的口腔健康和疾病本体（OHDO），以包括所有研究变量。然后，我们将OHDO与健康维护组织研究网络项目虚拟数据仓库（VDW）中的EDR数据关系数据集链接，并将OHDO中的数据转换为适合统计分析的数据集。SA 2将回答65岁及以上患者的两个研究问题：(1)汞合金修复体（AR）和复合修复体（CR）的寿命是否取决于患者的龋齿史？(2) AR和CR的寿命是否与根面是否参与修复有关？我们将通过分析老年患者的EDR数据来回答这些研究问题。我们的项目是创新的，因为它将在广泛的人群中大规模使用EDR数据，产生一个从EDR数据生成统计数据集的简化和可重复的过程，并为类似的研究提供有用的方法进步。该项目将解决对患者和牙医重要的研究问题；制定一种可推广的方法，从多个EDR系统中提取各种临床数据，并将其用于临床、比较有效性、流行病学和其他研究；并为牙科和医疗数据的联合分析创造未来的机会。

DESCRIPTION (provided by applicant): How patient-, tooth- and restoration-level factors affect the longevity of amalgam and composite restorations in elderly patient populations is an important question given the current national debate on the quality, cost and appropriateness of health care. Currently available results on restoration longevity in the elderly are limited in several ways (few studies on the elderly; most existing studies conducted outside the US with geographically limited, often specialized populations; small sample sizes; and inherent biases in data sources). This project proposes analyzing restoration longevity using electronic dental record (EDR) data from two major health maintenance organizations, HealthPartners and the Marshfield Clinic. We will do so in two specific aims (SA): (1) generate a research dataset from the Virtual Data Warehouse (VDW) for statistical analysis using an ontology-based method; and (2) perform statistical analysis of the dataset to determine factors influencing restoration longevity in the elderly. In SA 1, we will first extend the Oral Health and Disease Ontology (OHDO) being developed collaboratively at the University of Pittsburgh and the University at Buffalo to include all study variables. Then, we will link the OHDO to the relational dataset of EDR data in the Virtual Data Warehouse (VDW), a project of the Health Maintenance Organization Research Network and transform the data in the OHDO into a dataset suitable for statistical analysis. SA 2 will answer two research questions for patients 65 years and older: (1) Does the longevity of amalgam restorations (AR) and composite (CR) restorations depend on a patient's caries history? (2) Does the longevity of AR and CR depend on whether the root surface is involved in the restoration? We will answer these research questions by analyzing EDR data from a population of elderly patients. Our project is innovative because it will use EDR data on a large scale for a broad population, produce a streamlined and reproducible process of generating statistical datasets from EDR data, and offer a methodological advance useful for similar studies. The project will address research questions important to patients and dentists; produce a generalizable method for extracting a variety of clinical data from multiple EDR systems and using them for clinical, comparative effectiveness, epidemiological and other research; and create future opportunities for the conjoint analysis of dental and medical data.