Estimation of Periodontal Disease Progression in the Presence of Diagnostic Error

存在诊断错误时牙周病进展的估计

• 批准号: 8205368
• 负责人: Anthony Parker
• 金额: $ 4.26万
• 依托单位: MEDICAL UNIVERSITY OF SOUTH CAROLINA
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-08-01 至 2012-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8205368
• 关键词: Accounting; Address; Adult; Affect; Algorithms; American; Blood Glucose; Clinical; Clinical Data; Data; Dental Research; Dental caries; Dependence; Detection; Development; Diagnostic; Diagnostic Errors; Disease; Disease Progression; Early Diagnosis; Early treatment; Elderly; Evaluation; Generations; Goals; Health Care Costs; Heart Diseases; Incidence; Intervention; Measurement; Measures; Methods; Modeling; Oral health; Partner in relationship; Patients; Performance; Periodontal Diseases; Persons; Prevalence; Progressive Disease; Quality of life; Recording of previous events; Research; Research Personnel; Simulate; Specific qualifier value; Stroke; Structure; Tooth Loss; Weight; Woman; Work; bone loss; clinical research site; design; disease diagnosis; experience; improved; model design; models and simulation; prevent; research study; simulation

DESCRIPTION (provided by applicant): More than 75% of American adults are estimated to have some form of periodontal (gum) disease. Those with periodontal disease are more likely to develop heart disease or have difficulty controlling blood sugar than those without periodontal disease. In addition, women with gum disease are more likely to deliver preterm, low weight babies than those without gum disease [22], and elderly adults who have experienced bone or tooth loss as a result of periodontal disease, have a history of stroke compared to those with healthy gums [20]. Prompt and correct detection of disease helps to identify patients who may have an early clinical benefit from treatment which may reduce complications of untreated periodontal disease such as these. Early diagnosis and treatment is also important in preventing tooth loss, improving the patients' quality of life, and reducing dental health costs. Diagnostic (measurement) error is prevalent in dental research including periodontal research. It has long been recognized that measurement error can bias estimates obtained from error affected independent variables. In periodontal research studies, the probed pocket depth (PPD) is one measure often used to assess periodontal disease status. Current methods of measuring PPD at specified sites by clinical means are subject to measurement error. The models in this proposal are designed to reduce the bias in estimating the incidence of peridontal disease through the correction of PPD measurement error. In a simulation study, we will evaluate the performance of estimates from four models designed to correct for measurement error: the adapted Carlos-Senning and Lu models, the MC-SIMEX corrected model, and newly proposed beta-regression model. We compare the performance of these estimates to estimates obtained from a naive model not accounting for measurement error. PUBLIC HEALTH RELEVANCE: The primary goals of this research is to reduce the bias of estimates associated with independent variables measured with error in large scale oral health studies where periodontal disease status is assessed. The study will quantify the effect of PPD measurement error on the estimation of periodontal disease incidence. Results from this research will provide a model for use in oral health studies in the estimation of disease incidence in the presence of measurement error.

描述（由申请人提供）：据估计，超过75%的美国成年人患有某种形式的牙周（牙龈）疾病。有牙周病的人比没有牙周病的人更容易患心脏病或难以控制血糖。此外，患有牙龈疾病的女性比没有牙龈疾病的女性更有可能早产，低体重婴儿[22]，并且与牙龈健康的人相比，因牙周病而经历骨或牙齿缺失的老年人有中风史[20]。及时和正确的疾病检测有助于识别可能从治疗中获得早期临床益处的患者，这可能会减少未经治疗的牙周病的并发症。早期诊断和治疗对于预防牙齿脱落、提高患者的生活质量和降低牙科保健费用也很重要。诊断（测量）错误是普遍存在的牙科研究，包括牙周研究。长期以来，人们已经认识到，测量误差会使从受误差影响的自变量中获得的估计值产生偏差。在牙周病研究中，牙周袋探测深度（PPD）是一种经常用于评估牙周病状态的测量方法。目前通过临床手段在特定部位测量PPD的方法存在测量误差。本建议中的模型旨在通过校正PPD测量误差来减少估计围产期疾病发生率的偏倚。在模拟研究中，我们将评估四种模型的估计性能，这些模型旨在校正测量误差：适应的Carlos-Senning和Lu模型，MC-SIMEX校正模型和新提出的β回归模型。我们比较这些估计的性能，从一个天真的模型，不考虑测量误差的估计。 公共卫生相关性：本研究的主要目的是减少在大规模口腔健康研究中评估牙周病状态时与测量误差相关的独立变量估计值的偏倚。该研究将量化PPD测量误差对牙周病发病率估计的影响。这项研究的结果将提供一个模型，用于口腔健康研究中的疾病发病率的估计存在测量误差。