Development of the Dundee Caries Risk Assessment Model (DCRAM) – risk model development using a novel application of CHAID analysis

MacRitchie, Heather M. B.; Longbottom, Christopher; Robertson, Margaret; Nugent, Zoann; Ky, Chan; Radford, John; Pitts, Nigel

doi:10.1111/j.1600-0528.2011.00630.x

Cited by 40 publications

(63 citation statements)

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“…43 Some studies have assessed caries risk assessment instruments in children younger than 5 years of age, but the instruments were not administered by primary care providers or in primary care settings. These instruments often incorporate findings from an oral examination by dental personnel, and include tests not commonly obtained in primary care (such as mutans streptococci levels, saliva secretion level, or saliva buffer capacity), 69,70 likely limiting their applicability to primary care settings. 71,72 No trial specifically evaluated the effectiveness of parental or caregiver education on caries outcomes, although limited evidence from 2 trials suggests that multifactorial interventions that included an educational component could be effective.…”

Section: Discussionmentioning

confidence: 99%

Preventing Dental Caries in Children <5 Years: Systematic Review Updating USPSTF Recommendation

et al. 2013

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) and reference lists, we included trials and controlled observational studies on the effectiveness and harms of screening and treatments. One author extracted study characteristics and results, which were checked for accuracy by a second author. Two authors independently assessed study quality. RESULTS:No study evaluated effects of screening by primary care providers on clinical outcomes. One good-quality cohort study found pediatrician examination associated with a sensitivity of 0.76 for identifying a child with cavities. No new trials evaluated oral fluoride supplementation. Three new randomized trials were consistent with previous studies in finding fluoride varnish more effective than no varnish (reduction in caries increment 18% to 59%). Three trials of xylitol were inconclusive regarding effects on caries. New observational studies were consistent with previous evidence showing an association between early childhood fluoride use and enamel fluorosis. Evidence on the accuracy of risk prediction instruments in primary care settings is not available. CONCLUSIONS:There is no direct evidence that screening by primary care clinicians reduces early childhood caries. Evidence previously reviewed by the US Preventive Services Task Force found oral fluoride supplementation effective at reducing caries incidence, and new evidence supports the effectiveness of fluoride varnish in higher-risk children. All authors made substantial contributions to conception and design, acquisition of data, and analysis and interpretation of data, and gave final approval of the version to be published. Dr Chou drafted the article and revised it critically for important intellectual content. He is guarantor for this article. Drs Cantor, Zakher, Mitchell, and Pappas revised the article critically for important intellectual content. Staff at AHRQ and members of the USPSTF developed the scope of the work and reviewed draft manuscripts. Approval from AHRQ was required before the manuscript was submitted for publication, but the authors are solely responsible for the content and the decision to submit it for publication. 332CHOU et al by guest on May 11, 2018 http://pediatrics.aappublications.org/ Downloaded from Dental caries is an infectious process involving breakdown of the tooth enamel. 1,2 It is the most common chronic disease of children in the United States, and is increasing in prevalence among 2-to 5-yearolds. [3][4][5] Approximately three-quarters of children with caries have not received treatment. 5 Early childhood caries is associated with pain and tooth loss, as well as impaired growth, decreased weight gain, and negative effects on speech, appearance, self-esteem, school performance, and quality of life. 2,6,7 Dental caries disproportionately affects minority and economically disadvantaged children. 5 Risk factors for dental caries include high levels of colonization by cariogenic bacteria, frequent exposure to dietary sugar and refined carbohydrates, inappropriate bottle feeding, low saliva flow rates, developmental de...

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Section: Discussionmentioning

confidence: 99%

Preventing Dental Caries in Children <5 Years: Systematic Review Updating USPSTF Recommendation

et al. 2013

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“…MacRitchie et al, 2012 22 desarrollaron un modelo de evaluación de riesgo de caries en la ciudad de Dundee, Escocia. Estos autores realizaron el estudio utilizando un detector de interacción automática Chi Cuadrado que permite generar modelos para predecir el riesgo en niños de 4 años de edad.…”

Section: De Dundeeunclassified

“…Dos de los modelos de riesgo incluyeron cualquier grado de riesgo de caries (n=697, COPD> 0) en tanto los otros dos contemplaron un alto riesgo de caries (n=784, COPD > 3) dependiendo del nivel de detección de caries: d1 (esmalte y dentina) o d3 (dentina solamente). De los modelos obtenidos el que presentó mejor sensibilidad y especificidad fue el modelo de alto riesgo de caries (análisis CHAID) a nivel d3 de detección; el cual tuvo una sensibilidad del 65% y una especificidad del 69% 22 . .…”

Section: De Dundeeunclassified

“…Estas variables comportamentales tuvieron una magnitud, medida en Odd Ratios, de igual peso que la higiene bucal y la ingesta de azúcar. Generalmente, los modelos propuestos de CIT en la literatura son muy complejos y no son de fácil aplicación a nivel de atención primaria de salud 9,22 . El enfoque de los autores se basa en la identificación de las principales variables que se pueden supervisar fácilmente en la atención primaria de salud.…”

Section: Fierro C Y Otrosunclassified

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Modelos Explicativos De Caries De La Infancia Temprana

Fierro-Monti

Pérez

2017

RevFacOdonto

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ResumenLa caries de la infancia temprana (CIT) es una enfermedad crónica altamente prevalente en niños, siendo un problema de salud pública, porque afecta una población considerada vulnerable. La construcción de modelos, en la planificación y evaluación de intervenciones en salud, resulta una herramienta valiosa, siendo frecuentemente utilizados para descubrir su etiología así como predecir el curso de la enfermedad. Se han presentado 11 modelos explicativos de la caries de la infancia temprana construidos en diversas poblaciones mundiales, que presentan similitudes y diferencias propias de los estudios y sus poblaciones infantiles. Objetivo: Identificar a través del tiempo, los diferentes tipos de modelos explicativos gráficos de la CIT Método: La búsqueda bibliográfica se realizó en MEDLINE, EMBASE, LILACS, SciELO, Science Direct, IBECS, Cochrane y CENTRAL conjugando los términos "early childhood caries", "explanatory models", "risk models", " graphic models", "conceptual models" con límites de idioma inglés y español, publicados entre 1995 y 2017. Resultados: Se presentan 11 modelos gráficos explicativos de CIT realizados en EUA, Reino Unido, Suecia, China, Escocia, Chile, y Brasil. Conclusión: Los modelos teóricos son construidos a fin de explicar la causalidad de los procesos biológicos, psicológicos y sociales que intervienen en el desarrollo de la enfermedad. Los modelos exlicativos presentados dan cuenta de las similitudes y diferencias presentes a edades tempranas en la población estudiada para dar causalidad y predicción a la caries. PALABRAS CLAVE: modelos explicativos, modelos de riesgo de caries de la infancia temprana. AbstractEarly childhood caries (CIT) is a highly prevalent chronic disease in children, being a public health problem because it affects a population considered vulnerable. The construction of models, in the planning and evaluation of health interventions, is a valuable tool, being frequently used to discover its etiology as well as to predict the course of the disease. We have presented 11 explanatory models of early childhood caries constructed in diverse world populations, which present similarities and differences characteristic of studies and their children populations. Objective: To identify over time, the different types of graphic explanatory models of the CIT. METHODS: The literature search was carried out in MEDLINE, EMBASE, LILACS, SciELO, Science Direct, IBECS, Cochrane and CENTRAL, combining the terms "early childhood caries", "explanatory models", "risk models", "graphic models", "conceptual models "with limits of English and Spanish language, published between 1995 and 2017. Results: 11 CIT explanatory graphic models are presented in USA, UK, Sweden, China, Scotland, Chile, and Brazil. Conclusion: The theoretical models are constructed in order to explain the causality of the biological, psychological and social processes involved in the development of the disease. The explicative models presented account for the similarities and differences present at early ages in th...

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“…Debido a su carác-ter multifactorial, se debe recopilar información relacionada con el entorno individual, social y comunitario del preescolar. Para ello, se han desarrollado una amplia variedad de cuestionarios que abordan aspectos bioló-gicos, sociales, conductuales, culturales, relacionados con el desarrollo de la enfermedad (Ramos-Gómez et al, 2002;Marshall et al, 2003;Finlayson et al, 2006;Patir et al, 2008;Gao et al, 2010;MacRitchie et al, 2012).…”

Section: Introductionunclassified

Validación de un Cuestionario para Evaluar Riesgo de Caries en Preescolares en Santiago, Chile

Candiales

Cabello

Rodríguez

et al. 2018

Int. J. Odontostomat.

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RESUMEN: La Caries Temprana de la Infancia (CTI) es una forma de caries dental agresiva que afecta a niños, y en el último reporte nacional reveló una prevalencia de caries del 50 % en niños de 4 años de edad de la Región Metropolitana de Santiago (Soto et al., 2007). El objetivo de este estudio es validar un cuestionario que permita recolectar información relacionada con diversos factores de riesgo de caries en niños preescolares. Para la validación del cuestionario se determinó la validez de convergencia y discriminación, la consistencia interna y la confiabilidad test retest del instrumento en dos muestras independientes. Se aplicó el instrumento al cuidador principal de 118 preescolares entre 24 a 71 meses de edad, que asisten a jardines infantiles de dependencia particular (bajo riesgo de caries) y la Fundación INTEGRA (alto riesgo de caries) en la Región Metropolitana de Santiago, Chile. Se realizaron exámenes clínicos dentales por 2 odontólogos calibrados utilizando en el criterio OMS e ICDAS II. Se estimó un modelo de regresión logística y se evalúo la capacidad de discriminación del puntaje a través de una curva ROC. El cuestionario mostró una validez de discriminación de 0,95 entre ambos grupos y de la pregunta global 0,61 y una consistencia interna del cuestionario de 0,72. En la validez de convergencia se encontró que no existe asociación estadísticamente significativa entre el puntaje del cuestionario y la pregunta global dicotomizada (OD) 1,061. No obstante, se evidenció que si existe asociación estadísticamente significativa entre el puntaje del cuestionario y el grupo riesgo de caries (bajo y alto) (OD) 1,961. La estabilidad temporal mediante comparaciones Test -Retest calculado con el índice de Kappa osciló entre 0,37 a 1. Por lo tanto, se puede concluir que el presente cuestionario es un instrumento válido para discriminar riesgo de caries, permitiendo un mejor análisis de los determinantes de la caries dental en la población preescolar chilena.PALABRAS CLAVE: dental caries, evaluación de riesgo, preescolares.

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Development of the Dundee Caries Risk Assessment Model (DCRAM) – risk model development using a novel application of CHAID analysis

Abstract: An appropriate risk assessment model for use in a particular community setting predicting caries at age 4 years from data collected at age 1 year was developed. This has been termed the Dundee Caries Risk Assessment Model.

Cited by 40 publications

References 56 publications

Preventing Dental Caries in Children <5 Years: Systematic Review Updating USPSTF Recommendation

Preventing Dental Caries in Children <5 Years: Systematic Review Updating USPSTF Recommendation

Modelos Explicativos De Caries De La Infancia Temprana

Validación de un Cuestionario para Evaluar Riesgo de Caries en Preescolares en Santiago, Chile

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Development of the Dundee Caries Risk Assessment Model (DCRAM) – risk model development using a novel application of CHAID analysis

Abstract: An appropriate risk assessment model for use in a particular community setting predicting caries at age 4 years from data collected at age 1 year was developed. This has been termed the Dundee Caries Risk Assessment Model.

Cited by 40 publications

References 56 publications

Preventing Dental Caries in Children &lt;5 Years: Systematic Review Updating USPSTF Recommendation

Preventing Dental Caries in Children &lt;5 Years: Systematic Review Updating USPSTF Recommendation

Modelos Explicativos De Caries De La Infancia Temprana

Validación de un Cuestionario para Evaluar Riesgo de Caries en Preescolares en Santiago, Chile

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Preventing Dental Caries in Children <5 Years: Systematic Review Updating USPSTF Recommendation

Preventing Dental Caries in Children <5 Years: Systematic Review Updating USPSTF Recommendation