Analysis of Complex Caries Life Course Data in Inner City African-American Childr

内城非裔美国儿童复杂龋病生命历程数据分析

• 批准号: 8772028
• 负责人: Chenxi Li
• 金额: $ 15.77万
• 依托单位: MICHIGAN STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-10 至 2016-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8772028
• 关键词: Address; African American; Applications Grants; Caregivers; Characteristics; Child; Cities; Clinical Trials; Cohort Studies; Complex; Coupled; Data; Data Analyses; Databases; Dental caries; Disease; Epidemiologic Studies; Event; Exhibits; Future; Health; Individual; Investigation; Knowledge; Left; Lesion; Life Cycle Stages; Literature; Longitudinal Studies; Low income; Methodology; Michigan; Minority; Modeling; Nature; Oral; Oral cavity; Oral health; Outcome; Predisposition; Prevention; Recording of previous events; Research; Research Design; School Dentistry; Staging; Statistical Models; Surface; Time; Tooth structure; Underserved Population; Universities; Work; boys; early childhood; evidence base; girls; improved; inner city; interest; mandible/maxilla; markov model; medically underserved population; prevent; public health relevance; sound; success; tooth surface

DESCRIPTION (provided by applicant): Despite accumulated evidence that caries susceptibility varies within the oral cavity, the intra-oral life course of the disease remains relatively understudied. It is well known that caries susceptibility differs between the maxilla an mandible and also across individual teeth and their surfaces, but little is known about the timing and disease transition for these intra-oral characteristics. A unique database that provides detailed longitudinal intra-oral information for the study of caries life course is the Detroit Denal Health Project (DDHP) conducted by the University of Michigan School of Dentistry at Ann Arbor, Michigan. This is a longitudinal study designed to understand the oral health of low-income African-American children (0-5 years) and their main caregivers (14+ years) residing in the city of Detroit, Michigan. Among other information, this study comprises longitudinal investigations involving tooth-level and tooth-surface level information on caries life course which can provide answers to important research questions such as: which teeth or tooth surfaces transition faster from sound to noncavitated lesions and ultimately to cavitated lesions? Which teeth or tooth surfaces are more likely to transition reversely from noncavitated lesions to sound? Are there (left-right or upper-lower) symmetries in the mouth with respect to caries transition times? Are molars more likely to transition faster to higher disease stages in boys than girls? Analyzing caries life course data from the DDHP study is inherently complex because of interval-censored observations, a hierarchical intra-oral correlation and multiple states of caries lesions. There have been several works in the statistical literature which examine related issues and complications, but these works often accommodate only one or two of these complications. To our best knowledge, we are not aware of any statistical model that addresses all these complications simultaneously. This project specifically aims at developing semiparametric multi-state models for clustered interval-censored caries history data at both tooth and tooth-surface levels; and applying the developed models to extensively analyze the data from the DDHP study. Technically, the methodology will be built from the likelihood of multi- state models for interval-censored observations coupled with penalized likelihood estimation. Following the completion of this project, we hope to substantially improve our understanding of early childhood caries in low income inner city African-American children. Most importantly, the acquired knowledge may then facilitate future prevention and treatment of dental caries in these underserved populations.

描述（由申请人提供）：尽管积累的证据表明龋齿易感性在口腔内不同，但该疾病的口腔内生命过程仍然相对研究不足。众所周知，上颌骨和下颌骨之间以及各个牙齿及其表面之间的龋齿易感性不同，但对这些口腔内特征的时间和疾病转变知之甚少。一个独特的数据库，提供详细的纵向口腔内的龋齿生命过程的研究是底特律Denal健康项目（DDHP）进行的密歇根大学牙科学院在安阿伯，密歇根州。这是一项纵向研究，旨在了解居住在密歇根州底特律市的低收入非洲裔美国儿童（0-5岁）及其主要照顾者（14岁以上）的口腔健康。除其他信息外，这项研究包括纵向调查，涉及牙齿水平和牙齿表面水平的信息龋齿的生命过程中，可以提供答案的重要研究问题，如：牙齿或牙齿表面过渡更快的声音noncavitated病变，并最终空化病变？哪些牙齿或牙齿表面更有可能从非空洞病变转变为健全？在龋齿转变时间方面，口腔中是否存在（左右或上下）对称性？磨牙在男孩中更容易更快地过渡到更高的疾病阶段， 姑娘们分析DDHP研究的龋齿生命过程数据本身就很复杂，因为观察结果是区间删失的，口腔内的相关性是分层的，龋齿的状态是多种多样的 病变在统计文献中有几部研究相关问题和并发症的著作，但这些著作往往只涉及其中的一两个并发症。据我们所知，我们不知道有任何统计模型可以同时解决所有这些并发症。该项目的具体目标是在牙齿和牙齿表面水平上为聚类区间删失的龋齿历史数据开发半参数多状态模型;并应用开发的模型广泛分析DDHP研究的数据。从技术上讲，该方法将建立在区间删失观测的多状态模型的可能性加上惩罚似然估计。在这个项目完成后，我们希望能大大提高我们对低收入城市非裔美国儿童早期龋齿的理解。最重要的是，所获得的知识可能有助于这些服务不足的人群今后预防和治疗龋齿。