Performance of self-reported measures for periodontitis in rheumatoid arthritis and osteoarthritis

Brian W. Coburn, Harlan R. Sayles, Jeffrey B Payne, Robert S. Redman, Jeffery C. Markt, Mark W Beatty, Garth R. Griffiths, David J. McGowan, Ted R Mikuls

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Background: This study evaluates the performance of self-report against the reference standard of clinically defined periodontitis in patients with rheumatoid arthritis (RA) and osteoarthritis (OA) after accounting for factors associated with periodontitis. Methods: Six self-report periodontitis questions were evaluated in patients with RA and OA. Questions were validated against a reference standard of severe and moderate-to-severe periodontitis based on full-mouth examination. Multivariable logistic regression was used to evaluate the performance of: 1) self-report alone; 2) age, sex, education, and smoking status; and 3) a combination of the above. Model performance was assessed using the c-statistic. Convergent validity of self-reported "bone loss/deep pockets" and "loose teeth" was assessed; associations of self-report with RA disease characteristics were explored. Results: Self-report performed similarly in RA and OA, with individual question specificity for periodontitis ≥68% and sensitivity from 9.8% to 45%. Question-only models yielded c-statistics of 0.66 to 0.72, whereas risk factor-only models yielded c-statistics of 0.74 to 0.79. The highest-performing models incorporated both self-report questions and periodontitis risk factors, with c-statistics ≥0.79. Greater radiographic alveolar bone loss was observed among participants reporting "bone loss/deep pockets" (P <0.001) and "loose teeth" (P <0.001). Among patients with RA, "loose teeth," but not other self-report items, was associated with rheumatoid factor positivity (P = 0.047) and higher disease activity (P <0.001). Conclusions: Patient self-report, when combined with other risk factors, performs well in identifying periodontitis among patients with RA and OA. Self-report questions related to alveolar bone loss exhibit excellent convergent validity in these patient subsets.

Original languageEnglish (US)
Pages (from-to)16-26
Number of pages11
JournalJournal of periodontology
Volume86
Issue number1
DOIs
StatePublished - Jan 1 2015

Fingerprint

Periodontitis
Osteoarthritis
Self Report
Rheumatoid Arthritis
Alveolar Bone Loss
Tooth
Bone and Bones
Sex Education
Rheumatoid Factor
Mouth
Logistic Models
Smoking

Keywords

  • Arthritis
  • Osteoarthritis
  • Periodontitis
  • Rheumatoid
  • Rheumatoid factor
  • Self report
  • Sensitivity and specificity

ASJC Scopus subject areas

  • Periodontics

Cite this

Performance of self-reported measures for periodontitis in rheumatoid arthritis and osteoarthritis. / Coburn, Brian W.; Sayles, Harlan R.; Payne, Jeffrey B; Redman, Robert S.; Markt, Jeffery C.; Beatty, Mark W; Griffiths, Garth R.; McGowan, David J.; Mikuls, Ted R.

In: Journal of periodontology, Vol. 86, No. 1, 01.01.2015, p. 16-26.

Research output: Contribution to journalArticle

Coburn, Brian W. ; Sayles, Harlan R. ; Payne, Jeffrey B ; Redman, Robert S. ; Markt, Jeffery C. ; Beatty, Mark W ; Griffiths, Garth R. ; McGowan, David J. ; Mikuls, Ted R. / Performance of self-reported measures for periodontitis in rheumatoid arthritis and osteoarthritis. In: Journal of periodontology. 2015 ; Vol. 86, No. 1. pp. 16-26.
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AU - Coburn, Brian W.

AU - Sayles, Harlan R.

AU - Payne, Jeffrey B

AU - Redman, Robert S.

AU - Markt, Jeffery C.

AU - Beatty, Mark W

AU - Griffiths, Garth R.

AU - McGowan, David J.

AU - Mikuls, Ted R

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N2 - Background: This study evaluates the performance of self-report against the reference standard of clinically defined periodontitis in patients with rheumatoid arthritis (RA) and osteoarthritis (OA) after accounting for factors associated with periodontitis. Methods: Six self-report periodontitis questions were evaluated in patients with RA and OA. Questions were validated against a reference standard of severe and moderate-to-severe periodontitis based on full-mouth examination. Multivariable logistic regression was used to evaluate the performance of: 1) self-report alone; 2) age, sex, education, and smoking status; and 3) a combination of the above. Model performance was assessed using the c-statistic. Convergent validity of self-reported "bone loss/deep pockets" and "loose teeth" was assessed; associations of self-report with RA disease characteristics were explored. Results: Self-report performed similarly in RA and OA, with individual question specificity for periodontitis ≥68% and sensitivity from 9.8% to 45%. Question-only models yielded c-statistics of 0.66 to 0.72, whereas risk factor-only models yielded c-statistics of 0.74 to 0.79. The highest-performing models incorporated both self-report questions and periodontitis risk factors, with c-statistics ≥0.79. Greater radiographic alveolar bone loss was observed among participants reporting "bone loss/deep pockets" (P <0.001) and "loose teeth" (P <0.001). Among patients with RA, "loose teeth," but not other self-report items, was associated with rheumatoid factor positivity (P = 0.047) and higher disease activity (P <0.001). Conclusions: Patient self-report, when combined with other risk factors, performs well in identifying periodontitis among patients with RA and OA. Self-report questions related to alveolar bone loss exhibit excellent convergent validity in these patient subsets.

AB - Background: This study evaluates the performance of self-report against the reference standard of clinically defined periodontitis in patients with rheumatoid arthritis (RA) and osteoarthritis (OA) after accounting for factors associated with periodontitis. Methods: Six self-report periodontitis questions were evaluated in patients with RA and OA. Questions were validated against a reference standard of severe and moderate-to-severe periodontitis based on full-mouth examination. Multivariable logistic regression was used to evaluate the performance of: 1) self-report alone; 2) age, sex, education, and smoking status; and 3) a combination of the above. Model performance was assessed using the c-statistic. Convergent validity of self-reported "bone loss/deep pockets" and "loose teeth" was assessed; associations of self-report with RA disease characteristics were explored. Results: Self-report performed similarly in RA and OA, with individual question specificity for periodontitis ≥68% and sensitivity from 9.8% to 45%. Question-only models yielded c-statistics of 0.66 to 0.72, whereas risk factor-only models yielded c-statistics of 0.74 to 0.79. The highest-performing models incorporated both self-report questions and periodontitis risk factors, with c-statistics ≥0.79. Greater radiographic alveolar bone loss was observed among participants reporting "bone loss/deep pockets" (P <0.001) and "loose teeth" (P <0.001). Among patients with RA, "loose teeth," but not other self-report items, was associated with rheumatoid factor positivity (P = 0.047) and higher disease activity (P <0.001). Conclusions: Patient self-report, when combined with other risk factors, performs well in identifying periodontitis among patients with RA and OA. Self-report questions related to alveolar bone loss exhibit excellent convergent validity in these patient subsets.

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KW - Osteoarthritis

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KW - Rheumatoid

KW - Rheumatoid factor

KW - Self report

KW - Sensitivity and specificity

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