Premium
Performance of Self‐Reported Measures for Periodontitis in Rheumatoid Arthritis and Osteoarthritis
Author(s) -
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.
Publication year - 2015
Publication title -
journal of periodontology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.036
H-Index - 156
eISSN - 1943-3670
pISSN - 0022-3492
DOI - 10.1902/jop.2014.140339
Subject(s) - periodontitis , medicine , rheumatoid arthritis , osteoarthritis , logistic regression , dental alveolus , tooth loss , dentistry , clinical attachment loss , physical therapy , oral health , pathology , alternative medicine
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.