The impact of periodontitis exposure misclassification bias from partial-mouth measurements on association with diabetes and cardiovascular disease
(Journal of Clinical Periodontology; doi: 10.1111/jcpe.13376)
Talal S. Alshihayb, Elizabeth A. Kaye, Yihong Zhao, Cataldo W. Leone, Brenda Heaton
Large health studies do not always examine every tooth surface. Researchers asked whether checking only part of the mouth changes the estimated relationship between gum disease, diabetes and cardiovascular disease.
The analysis used detailed examinations from 9,575 US adults. Researchers compared the full-mouth information with several shorter examination protocols simulated from the same data. They then repeated analyses of self-reported diabetes and cardiovascular disease.
Shorter examinations sometimes placed people in a different gum disease category. This changed the strength, and occasionally the direction, of the observed associations. No single partial examination method performed best in every situation. Differences also depended on the disease definition, the outcome being studied and the number of teeth present.
This is a reminder that apparently conflicting studies may measure gum disease differently. It does not mean every brief dental screening is inappropriate: screening and a full diagnostic examination have different purposes. Nor does it establish a new treatment or personal risk estimate for diabetes. When interpreting research, it is useful to know whether participants had a detailed clinical assessment or whether disease was estimated from a smaller set of measurements.
The main contribution is to show how research methods affect the conclusions we draw. Results depend on the data available, the measurements chosen and the assumptions made in analysis. A more detailed method may reduce one problem without removing every possible source of bias. These findings do not measure the benefit of a new treatment. For a patient reading research, useful questions are whether disease was measured reliably, whether comparison groups were similar and whether the conclusions match what the study actually tested.
Read the full article Back to ResearchHosted by #diabeteschat, join Dr Varkha Rattu and the team behind the Periodontitis-Diabetes Hub for an insightful discussion exploring the importance of managing periodontitis and diabetes.
Read moreDr Antoniszczak will present a lecture about the oral health challenges among people living with diabetes. This lecture explores the key challenges faced by individuals living with diabetes, focusing on…
Read moreHosted by #diabeteschat, join Dr Varkha Rattu and the team behind the Periodontitis-Diabetes Hub for an insightful discussion exploring the importance of managing periodontitis and diabetes.
Read moreDr Antoniszczak will present a lecture about the oral health challenges among people living with diabetes. This lecture explores the key challenges faced by individuals living with diabetes, focusing on the relationship between diabetes and oral health.
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