title: Validity of screening methods for periodontitis using salivary hemoglobin level and self-report questionnaires in people with disabilities.
abstract: BACKGROUND
  The aim of this study is to evaluate the validity of screening methods in predicting periodontitis in people with disabilities using the objective salivary hemoglobin level, a subjective self-report questionnaire, and a combined model of the two methods with demographic characteristics.
  
  
  METHODS
  The participants were 195 patients with disabilities aged >18 years who were examined using the community periodontal index (CPI), salivary hemoglobin level, and answers to 10 self-report questions (n = 192). Multivariable logistic regression and receiver operating characteristic (ROC) curve analysis were performed to evaluate the validity of the methods and the combined model in predicting the prevalence of ≥CPI 3 (probing depth [PD] ≥4 mm) or CPI 4 (PD ≥6 mm).
  
  
  RESULTS
  Overall, 75.9% of the study group (148 of 195) were diagnosed with ≥CPI 3, and 38.5% of the study group (75 of 195) were diagnosed with CPI 4. The areas under the ROC curve (AUCs) of the salivary hemoglobin level were 0.578 (sensitivity of 41% and specificity of 77%) and 0.662 (sensitivity of 53% and specificity of 75%) for predicting the prevalence of ≥CPI 3 and CPI 4, respectively. Multivariable modeling incorporating four different questions for predicting ≥CPI 3 or CPI 4 indicated higher AUCs of 0.710 and 0.732, respectively, yielding higher sensitivity (55% for ≥CPI 3 and 69% for CPI 4) than that of salivary hemoglobin level. The most useful prediction models for ≥CPI 3 or CPI 4 were combined models, which yielded AUCs of 0.773 and 0.807, respectively, with sensitivity values of 70% and specificity values >75%.
  
  
  CONCLUSIONS
  The salivary hemoglobin level, self-report questionnaire, and the combined method demonstrated screening potential that could predict the population prevalence of ≥CPI 3 or CPI 4.
authors.affiliation: Department of Preventive Dentistry and Public Oral Health, Oral Science Research Institute, Yonsei University College of Dentistry, Seoul, Republic of Korea.
authors.forename: Sun-Hei
authors.initials: SH
authors.lastname: Nam
authors.forename: Hoi-In
authors.initials: HI
authors.lastname: Jung
authors.forename: Si-Mook
authors.initials: SM
authors.lastname: Kang
authors.forename: Daisuke
authors.initials: D
authors.lastname: Inaba
authors.forename: Ho-Keun
authors.initials: HK
authors.lastname: Kwon
authors.forename: Baek-Il
authors.initials: BI
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016301:Alveolar Bone Loss / Q000175:diagnosis; D019540:Area Under Curve; D001294:Attitude to Health; D006233:Persons with Disabilities; D005260:Female; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000175:diagnosis; D010518:Periodontitis / Q000175:diagnosis*; D011237:Predictive Value of Tests; D012372:ROC Curve; D015203:Reproducibility of Results; D012463:Saliva / Q000737:chemistry*; D057566:Self Report; D012680:Sensitivity and Specificity; D012907:Smoking; D011795:Surveys and Questionnaires; D014086:Tooth Mobility / Q000175:diagnosis; D055815:Young Adult
chemical_list: D006454:Hemoglobins
keywords: Disabled persons; ROC curve; hemoglobins; periodontal index; periodontitis; self-report.