Analysis of Complex Caries Life Course Data in Inner City African-American Childr

内城非裔美国儿童复杂龋病生命历程数据分析

• 批准号: 8772028
• 负责人: Chenxi Li
• 金额: $ 15.77万
• 依托单位: MICHIGAN STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-10 至 2016-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8772028
• 关键词: Address; African American; Applications Grants; Caregivers; Characteristics; Child; Cities; Clinical Trials; Cohort Studies; Complex; Coupled; Data; Data Analyses; Databases; Dental caries; Disease; Epidemiologic Studies; Event; Exhibits; Future; Health; Individual; Investigation; Knowledge; Left; Lesion; Life Cycle Stages; Literature; Longitudinal Studies; Low income; Methodology; Michigan; Minority; Modeling; Nature; Oral; Oral cavity; Oral health; Outcome; Predisposition; Prevention; Recording of previous events; Research; Research Design; School Dentistry; Staging; Statistical Models; Surface; Time; Tooth structure; Underserved Population; Universities; Work; boys; early childhood; evidence base; girls; improved; inner city; interest; mandible/maxilla; markov model; medically underserved population; prevent; public health relevance; sound; success; tooth surface

DESCRIPTION (provided by applicant): Despite accumulated evidence that caries susceptibility varies within the oral cavity, the intra-oral life course of the disease remains relatively understudied. It is well known that caries susceptibility differs between the maxilla an mandible and also across individual teeth and their surfaces, but little is known about the timing and disease transition for these intra-oral characteristics. A unique database that provides detailed longitudinal intra-oral information for the study of caries life course is the Detroit Denal Health Project (DDHP) conducted by the University of Michigan School of Dentistry at Ann Arbor, Michigan. This is a longitudinal study designed to understand the oral health of low-income African-American children (0-5 years) and their main caregivers (14+ years) residing in the city of Detroit, Michigan. Among other information, this study comprises longitudinal investigations involving tooth-level and tooth-surface level information on caries life course which can provide answers to important research questions such as: which teeth or tooth surfaces transition faster from sound to noncavitated lesions and ultimately to cavitated lesions? Which teeth or tooth surfaces are more likely to transition reversely from noncavitated lesions to sound? Are there (left-right or upper-lower) symmetries in the mouth with respect to caries transition times? Are molars more likely to transition faster to higher disease stages in boys than girls? Analyzing caries life course data from the DDHP study is inherently complex because of interval-censored observations, a hierarchical intra-oral correlation and multiple states of caries lesions. There have been several works in the statistical literature which examine related issues and complications, but these works often accommodate only one or two of these complications. To our best knowledge, we are not aware of any statistical model that addresses all these complications simultaneously. This project specifically aims at developing semiparametric multi-state models for clustered interval-censored caries history data at both tooth and tooth-surface levels; and applying the developed models to extensively analyze the data from the DDHP study. Technically, the methodology will be built from the likelihood of multi- state models for interval-censored observations coupled with penalized likelihood estimation. Following the completion of this project, we hope to substantially improve our understanding of early childhood caries in low income inner city African-American children. Most importantly, the acquired knowledge may then facilitate future prevention and treatment of dental caries in these underserved populations.

描述（由申请人提供）：尽管积累的证据表明口腔内的龋齿易感性存在差异，但对该疾病的口腔内生命过程的研究仍然相对不足。众所周知，上颌骨和下颌骨之间以及各个牙齿及其表面之间的龋齿易感性有所不同，但对于这些口腔内特征的时间和疾病转变却知之甚少。位于密歇根州安娜堡市的密歇根大学牙科学院开展的底特律牙科健康项目 (DDHP) 是一个独特的数据库，可为研究龋齿生命过程提供详细的纵向口腔内信息。这是一项纵向研究，旨在了解居住在密歇根州底特律市的低收入非裔美国儿童（0-5 岁）及其主要照顾者（14 岁以上）的口腔健康状况。除其他信息外，这项研究还包括涉及龋齿生命历程的牙齿水平和牙齿表面水平信息的纵向调查，这些信息可以为重要的研究问题提供答案，例如：哪些牙齿或牙齿表面从健全到非空洞病变并最终到空洞病变的转变速度更快病变？哪些牙齿或牙齿表面更有可能从非空洞病变反向过渡到健全？口腔中龋齿过渡时间是否对称（左右或上下）？与男孩相比，磨牙是否更有可能更快地过渡到更高的疾病阶段 女孩们？由于间隔删失观察、分层口腔内相关性和龋齿的多种状态，分析 DDHP 研究中的龋齿生命过程数据本质上是复杂的 病变。统计文献中已经有一些研究相关问题和并发症的著作，但这些著作通常只涉及其中的一两个并发症。据我们所知，我们不知道有任何统计模型可以同时解决所有这些复杂问题。该项目的具体目标是为牙齿和牙齿表面水平上的聚类区间删失龋病历史数据开发半参数多状态模型；并应用开发的模型广泛分析 DDHP 研究的数据。从技术上讲，该方法将根据区间审查观测的多状态模型的可能性以及惩罚似然估计来构建。该项目完成后，我们希望能够大幅提高我们对低收入内城区非裔美国儿童早期龋齿的了解。最重要的是，所获得的知识可能有助于未来预防和治疗这些服务不足的人群中的龋齿。