Leveraging Electronic Dental Record Data for Clinical Research in the National Dental PBRN Practices

Abstract

Objectives The aim of this study is to determine the feasibility of conducting clinical research using electronic dental record (EDR) data from U.S. solo and small-group general dental practices in the National Dental Practice-Based Research Network (network) and evaluate the data completeness and correctness before performing survival analyses of root canal treatment (RCT) and posterior composite restorations (PCR). Methods Ninety-nine network general dentistry practices that used Dentrix or EagleSoft EDR shared de-identified data of patients who received PCR and/or RCT on permanent teeth through October 31, 2015. We evaluated the data completeness and correctness, summarized practice, and patient characteristics and summarized the two treatments by tooth type and arch location. Results Eighty-two percent of practitioners were male, with a mean age of 49 and 22.4 years of clinical experience. The final dataset comprised 217,887 patients and 11,289,594 observations, with the observation period ranging from 0 to 37 years. Most patients (73%) were 18 to 64 years old; 56% were female. The data were nearly 100% complete. Eight percent of observations had incorrect data, such as incorrect tooth number or surface, primary teeth, supernumerary teeth, and tooth ranges, indicating multitooth procedures instead of PCR or RCT. Seventy-three percent of patients had dental insurance information; 27% lacked any insurance information. While gender was documented for all patients, race/ethnicity was missing in the dataset. Conclusion This study established the feasibility of using EDR data integrated from multiple distinct solo and small-group network practices for longitudinal studies to assess treatment outcomes. The results laid the groundwork for a learning health system that enables practitioners to learn about their patients' outcomes by using data from their own practice.

Augmenting the Clinical Data Sources for Enigmatic Diseases: A Cross-Sectional Study of Self-Tracking Data and Clinical Documentation in Endometriosis

“…Finally, we note the challenges of investigations in the EHR, a topic extensively discussed in the literature, 106,107 which might have influenced our results. The ETL process that converts the clinical data into the OMOP data tables is a dynamic process that improves over time, but is not completely error free.…”

Does Nonsurgical Periodontal Treatment Improve Systemic Health?

“…Furthermore, while RCTs often have high internal validity, they may suffer from low external validity, potentially limiting the generalizability of their findings. One notable opportunity for research complementing RCTs is studying medical and dental health record data of the same patients and using self-reported medical history information contained within an electronic dental record (EDR) (Song et al 2013; Merchant and Virani 2017; Thyvalikakath et al 2020). With the increasing use of EDR data to determine dental treatment effectiveness (Siddiqui et al 2017; Thyvalikakath et al 2020), researchers can conduct large-scale observational studies on available electronic health and dental data in a potentially ethical, feasible, and cost-efficient way (Merchant et al 2016; Merchant and Virani 2017).…”

“…One notable opportunity for research complementing RCTs is studying medical and dental health record data of the same patients and using self-reported medical history information contained within an electronic dental record (EDR) (Song et al 2013; Merchant and Virani 2017; Thyvalikakath et al 2020). With the increasing use of EDR data to determine dental treatment effectiveness (Siddiqui et al 2017; Thyvalikakath et al 2020), researchers can conduct large-scale observational studies on available electronic health and dental data in a potentially ethical, feasible, and cost-efficient way (Merchant et al 2016; Merchant and Virani 2017). Given the large sample sizes, high granularity, and high dimensionality of data obtained by linking of EHR and EDR data (St Sauver et al 2017; Patel et al 2018), robust analytic approaches and quasi-experimental designs can be used to generate high quality, causal evidence.…”

Use of digital periodontal data to compare periodontal treatment outcomes in a practice-based research network (PBRN): a proof of concept

“…Hence, these records can also be used for scientific investigations and digitally collected to support a practice-based research network. Worldwide, a few studies have already been carried out in which electronic dental record data from practice-based research network practices have been examined with regard to assess dental treatment outcomes [ 9 – 12 ]. For example, electronic data from a dutch practice based research network, which consisted of 24 dental practices, was collected and examined with regard to the survival rate of direct restorations.…”