Caries Risk Assessment and Referral Tool (CRA‐RT)—A novel risk scoring system for early childhood caries in community settings

Abstract

Objective To develop a brief and simple, easy‐to‐administer, culturally sensitive, reliable and valid risk scoring system for early childhood caries based only on behavioural and other nonclinical risk factors. The purpose was to allow risk scoring by child care providers without clinical examination in order to guide dental referral in a community setting. Methods A cross‐sectional study using stratified multistage cluster sampling was conducted among 559 preschool children and their mothers in Anganwadi centres and Preprimary schools in Thiruvananthapuram district, Kerala, India. All steps in the development of a new tool were carried out. Exploratory factor analysis and principal component analysis with Varimax rotation were employed for item reduction. Reliability and validity assessments were also performed. Past caries experience was recorded as dmft scores and the validity hypothesis of higher dmft scores in children with higher caries risk scores was also verified as an additional measure of construct validity. Results The newly developed Caries Risk Assessment and Referral Tool (CRA‐RT) is presented as a unidimensional, 11‐item, discriminative tool which showed high test‐retest reliability (ICC = 0.8), high inter‐rater reliability (ICC = 0.8) and acceptable internal consistency (Cronbach's alpha = 0.6). Face, content and construct validity have been demonstrated. Children with higher CRA‐RT scores were having higher dmft scores, and it provided an additional evidence for the construct validity of the tool. Conclusion CRA‐RT is a simple, valid and reliable novel risk scoring system for ECC, to be used in a nondental, nonmedical setting. The proposed tool contains those behavioural risk or protective factors, the presence or absence of which could be assessed by interviewing the mother. The quick and the easy risk scoring pattern with a cut‐off score can guide the dental referral of preschool children by child care providers in a community setting.

A mixed methods approach to obtaining health care provider feedback for the development of a Canadian pediatric dental caries risk assessment tool for children <6 years

“…However, its use is intended for dental health care providers (50). While this project appears to be the first to report on the qualitative analysis of feedback acquired during the development of a CRA tool, other studies have expressed similar preferences and characteristics of an ideal CRA tool, such as the need for it to be quick to complete, easy to score, and to have clear cutoffs for risk levels to aid in the referral of high-risk patients to dental health care providers (38,42). The findings of this project are congruent with these preferences and should find to be useful for the development of CRA tools to come.…”

“…However, the apps have to be informed by health professionals, with good design detail, grounded and validated for use, as the Canadian CRA tool has been (33,34). Although there have been numerous studies that have investigated caries risk factors and the predictive validity of CRA tools, this paper appears to be the first to report on the qualitative analysis of feedback acquired through pilot testing of a CRA tool indicated for use by non-dental primary health care providers (9,25,(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49). A similar British study has reported on feedback from the pilot testing of an online integrated oral health and risk assessment tool (DEPPA).…”

Development and validation of cultural competence assessment tool for healthcare professionals, India

“…Existing cultural competence assessment scales had limited applications in the Indian setting due to the country's diversity of cultures and healing systems. Moreover, existing scales varied widely in their interpretation of “culture,” “cultural competence,” and therefore the assessments ( 15 ). Most of these tools were group-specific, focusing only on nurses, pharmacists, and dentists, thereby curtailing their application in the comprehensive assessment of cultural competence at the organization or national level ( 16 ).…”

Early Childhood Predictors for Dental Caries: A Machine Learning Approach

“…Other variables that have been associated with caries development during the life course through traditional statistical models could be easier to be assessed, such as socioeconomic, psychosocial, and behavioral patterns in early childhood (Peres et al 2009; Emmanuelli et al 2021). Therefore, the elaboration of simpler and easy-to-implement models with more accurate prediction could favor more rational use of health resources (Muraleedhar Seetha et al 2020).…”