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Design and analysis considerations for a longitudinal study of periodontal disease
Author(s) -
Feldman Roy S.,
Alman John E.,
Chauncey Howard H.
Publication year - 1986
Publication title -
journal of clinical periodontology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.456
H-Index - 151
eISSN - 1600-051X
pISSN - 0303-6979
DOI - 10.1111/j.1600-051x.1986.tb01498.x
Subject(s) - medicine , interim , socioeconomic status , edentulism , family medicine , gerontology , population , longitudinal study , data collection , cohort , oral health , environmental health , pathology , statistics , mathematics , archaeology , history
Perception and concern for the health changes in our aging population led the Veterans Administration to initiate an interdisciplinary and longitudinal investigation of the aging process, the Veterans Administration Normative Aging Study, in 1963. A cohort of the 2,280 healthy men of this study self‐selected to enroll in the dental longitudinal study, an investigation of oral health in these healthy males. In 1968, 1,221 men between the ages of 25 and 75 began with a baseline cycle of 5 general series of examinations, including an interim health history and survey of dietary habits; masticatory performance and taste thresholds; salivary analyses; oral cytologic and radiographic survey and comprehensive clinical data on caries and periodontal status. Design considerations for the Dental Longitudinal Study included prospective planning of specific oral variables to be recorded, and provision of collection techniques to allow for additional analyses based on a wide menu of retrospective data. The volunteer cohort was screened to obtain men who met stringent general health criteria, who represented wide socioeconomic ranges and would likely remain geographically stable. Importantly, enrollment in the parent study was without regard for dental status or oral health. Administrative design considerations included orderly transfer for exam data to machine‐readable format by use of optical scan forms designed to register specific oral variables, with security preserved for the primary source records and rapid record retrieval. Additional data collection requiring manual coding was designed to transfer spreadsheets of clinical impressions and diagnoses to computer retrieval protocols. Provisions for recording of exceptional circumstances, i.e., salient oral pathology, were recognized and the optical scan forms modified to index and retrieve such cases. Clinical examination design considerations included independence of oral examination from the radiographic survey and reading, and isolation of each cycle of tests from any other. Attempts to contain examiner variability included use of a solo examiner and radiographic reader with a two‐stage calibration series of exercises to achieve reproducibility. To date, 725 men have been examined over 4 cycles of investigation encompassing baseline and 3 longitudinal examinations, each at 3‐year intervals. The specific indexes scored in this study were designed to evaluate dental and periodontal status on a population of almost epidemiologic proportions while retaining clinically relevant methodologies. The Dental Longitudinal Study continues as an ongoing investigation of the distribution, determinants, changes and interrelationships observed in oral health, function and disease. Cross‐sectional and longitudinal analysis has proceeded to correlate oral health with habit histories, loss of teeth, restorative dental experience, drug intake and other variables of contemporary life.