Validity of self-reported measures for surveillance of periodontal disease in two western New York population-based studies.
BACKGROUND
Public health and other population-based studies often depend on participants' self-reported disease status to assess prevalence, incidence, and disease trends. We sought to assess the feasibility of self-reported periodontal disease measures using dental history questions combined with demographic and medical history to predict periodontal disease.


METHODS
We evaluated results from two separate population-based studies carried out at the University at Buffalo, Buffalo, New York, i.e., the "Periodontal Infection and Risk for Myocardial Infarction Study," a study of 1,578 adults assessing the association between periodontal disease and myocardial infarction and the "Periodontal Disease Research Center" (the Erie County Study), an epidemiologic risk assessment study of 1,438 adults. In each study, an extensive list of oral health questions was asked, and a comprehensive medical history, blood analysis using chemistry and hematology tests, and demographic data were collected.


RESULTS
Using a predefined measure of severity of periodontal disease, we compared patients with severe disease to all others (i.e., those with moderate and no or mild disease). We examined areas under the curve (AUC) of the receiver operating curve to determine the best models, adding one, two, or three dental variables in all possible combinations. The AUC maximized at 0.76, and the combined sensitivity and specificity maximized at 142 and were comparable in both studies.


CONCLUSIONS
Self-reported measures of periodontal disease are moderately predictive of clinical attachment loss. The demographic variables of age, race, smoking, gender, and diabetes mellitus accounted for much of the predictive power for self-reported periodontal disease; however, increases in sensitivity and specificity in the C statistics occurred when questions, including "Gum surgery in the past?," "Sore gums in the past?," "Scaling in the past?," "Bleeding gums now?," "Periodontal surgery in the past 2 years?," and "Chewing satisfaction?," were added to the model.
Genco
Robert J
RJ
Department of Oral Biology, School of Dental Medicine, State University of New York at Buffalo, Buffalo, New York 14228, USA. rjgenco@buffalo.edu
Falkner
Karen L
KL
Grossi
Sara
S
Dunford
Robert
R
Trevisan
Maurizio
M
D000328:Adult; D000367:Age Factors; D000368:Aged; D016301:Alveolar Bone Loss / Q000453:epidemiology; D001774:Blood Chemical Analysis; D003920:Diabetes Mellitus / Q000453:epidemiology; D005240:Feasibility Studies; D005260:Female; D005544:Forecasting; D006801:Humans; D008297:Male; D008487:Medical History Taking; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D009909:Oral Health; D017622:Periodontal Attachment Loss / Q000453:epidemiology; D010510:Periodontal Diseases / Q000453:epidemiology*; D010512:Periodontal Index; D011159:Population Surveillance; D044469:Racial Groups / Q000706:statistics & numerical data; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology; D011795:Surveys and Questionnaires; D016388:Tooth Loss / Q000453:epidemiology