Statistical Methods for Complex Dependent Dental Data

描述(由申请人提供)：尽管有许多统计分析来评估乳牙期的龋齿模式，但仍然有一些基本的问题仍然没有得到回答。例如，在牙科医生中，人们普遍认为口腔中存在着相对于龋齿的空间对称性，但这一点从未在统计学意义上得到证明。比利时佛兰德斯的Signal Tandmobiel项目是一个独特的数据库，它提供了有关龋齿的详细牙齿水平数据，这可能有助于回答其中一些问题。这项建议是为了进行一项非常广泛的研究，包括对佛兰德学龄儿童口腔卫生的横断面和纵向调查。其目的是评估在出生的儿童口腔卫生的决定因素，并评估每年在随机选择的学校开展口腔卫生教育的效果。由于口腔内表面固有的空间关联以及同一表面随着时间的推移而产生的重复测量，对该数据的牙齿表面水平分析带来了许多困难。这项建议的目的是开发一种统计方法，用于对这项广泛的流行病学研究产生的龋齿数据进行二次分析。具体地说，我们建议(1)开发时空二进制数据的统计模型，并开发应用于乳牙龋齿的多变量时间事件数据模型，这些模型将被用于回答与牙齿表面对龋齿的易感性经验、口腔相对于龋齿的对称性以及根据龋病风险组的表面易感性差异有关的问题；(2)监控所提出的统计模型的质量；以及(3)调查缺失数据机制对所提出的回归模型的影响。这项统计研究的一个关键目标是提高我们设计、分析和解释牙科研究中临床试验和流行病学研究产生的复杂相关数据的能力。

DESCRIPTION (provided by applicant): Despite numerous statistical analyses to assess the pattern of dental caries in primary dentition, there are still some fundamental questions that remain unanswered. As an example, it is well believed among dentist that there are spatial symmetries in the mouth with respect to caries, but this has never been shown in a statistical sense. A unique database that provides detailed tooth-level data with respect to dental caries, which could help answer some of these questions, is the Signal Tandmobiel project in Flanders (Belgium). This proposal is for a very extensive study that comprises both cross-sectional and longitudinal investigations of oral hygiene among Flemish schoolchildren. Its objectives are to assess determinants of oral hygiene among children born in 1989 and to assess the effect of yearly oral hygiene education conducted at randomly selected schools. A tooth-surface level analysis of this data poses a number of difficulties due to inherent spatial association of surfaces in the mouth and repeated measurements generated from the same surface over time. The objective of this proposal is to develop a statistical methodology for secondary analysis of dental caries data generated from this extensive epidemiologic study. Specifically, we propose (1) to develop statistical models for spatial-temporal binary data and develop models for multivariate time-to-event data with applications to dental caries in primary teeth, which will be used to answer questions related to tooth surface susceptibility to caries experience, symmetries in the mouth with respect to dental caries, and differences in surface susceptibility according to caries risk groups; (2) to monitor the quality of the proposed statistical models; and (3) to investigate the influence of the missing data mechanism on the proposed regression models. A key goal of this statistical study is to improve our ability to design, analyze, and interpret complex dependent data generated from clinical trials and epidemiologic studies in dental research.