Accuracy of a 7-Item Patient-Reported Stand-Alone Tool for Periodontitis Screening

Abstract

Periodontitis is interrelated with various other chronic diseases. Recent evidence suggests that treatment of periodontitis improves glycemic control in diabetes patients and reduces the costs of diabetes treatment. So far, however, screening for periodontitis in non-dental settings has been complicated by a lack of easily applicable and reliable screening tools which can be applied by non-dental professionals. The purpose of this study was to assess the diagnostic accuracy of a short seven-item tool developed by the German Society for Periodontology (DG PARO) to screen for periodontitis by means of patient-reported information. A total of 88 adult patients filled in the patient-reported Periodontitis Risk Score (pPRS; range: 0 points = lowest periodontitis risk; 20 points = very high periodontitis risk) questionnaire before dental check-up at Heidelberg University Hospital. Subsequent clinical assessments according to Periodontal Screening and Recording (PSR®) were compared with pPRS scores. The diagnostic accuracy of pPRS at different cutoff values was assessed according to sensitivity, specificity, positive, and negative predictive values, as well as Receiver-Operator-Characteristic curves, Area Under the Curve (AUC), and logistic regression analysis. According to combined specificity and sensitivity (AUC = 0.86; 95%-CI: 0.76–0.95), the diagnostic accuracy of the pPRS for detecting periodontal inflammation (PSR® ≥ 3) was highest for a pPRS cutoff distinguishing between pPRS scores < 7 vs. ≥ 7. Patients with pPRS scores ≥ 7 had a 36.09 (95%-CI: 9.82–132.61) times higher chance of having a PSR® ≥ 3 than patients with scores < 7. In conclusion, the pPRS may be considered an appropriately accurate stand-alone tool for the screening for periodontitis.

External validation of a rapid, non-invasive tool for periodontitis screening in a medical care setting

“…Previous studies [18,[24][25][26][27][28] in the USA, Spain, France, and Germany were performed in a similar way as the study from Verhulst et al [1]. They all used only SROH questions and demographic data to predict severe periodontitis; no oral examination was needed to predict the periodontal state.…”

“…The Spanish [25,26] and French [24] studies used the SROH questions from Eke et al [18], similar to the current study. The studies from Germany [27,28] used SROH items developed by the German Society for Periodontology. However, none of these studies, except the one from Zhan et al [28], what would result if the predicted probability was the same as the actual probability of the model so that the prediction is neither underestimated nor overestimated Fig.…”

Modelos de autoreportes para detección de enfermedades periodontales

“…(Reiniger et al, 2019). Por su parte, Sekundo et al (2021), elaboraron un estudio de 88 participantes, con una media de edad de 57,7 años. Diseñaron una puntuación de riesgo de periodontitis informada por el paciente (pPRS), como se puede observar en la Figura 2 referente a la calificación de riesgos periodontales, en la cual se evaluaron varios valores de corte.…”

“…Con este fin, el pPRS puede proporcionar una herramienta adecuada para complementar dichas pautas para el cribado de periodontitis por parte de profesionales médicos. Si el pPRS está destinado a ser utilizado para grandes masas de población y por otros profesionales médicos en general, un enfoque en la generación de un sitio en línea o basado en una aplicación móvil sería más apropiado y justificaría más pruebas (Sekundo et al, 2021), lo cual sería de gran utilidad para facilitar el manejo de datos.…”

“…de una herramienta independiente de 7 elementos informada por el paciente para el cribado de periodontitis. (Sekundo et al, 2021).…”