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）：尽管累积的证据表明龋齿易感性在口腔内有所不同，但该疾病的口腔内生命过程仍然相对研究。众所周知，龋齿的敏感性在下颌骨和跨个体牙齿及其表面之间有所不同，但对这些口腔内特征的时机和疾病过渡知之甚少。一个独特的数据库为Caries Life课程提供详细的纵向内部信息是由密歇根州Ann Arbor的密歇根大学牙科学院进行的底特律居住健康项目（DDHP）。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）及其主要护理人员（14岁以上）的口腔健康。除其他信息外，这项研究包括涉及Caries Life课程的牙齿水平和牙齿表面水平的纵向研究，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声音到非储存的病变更快地过渡到非浪费的病变，最终到达洞穴的病变？哪些牙齿或牙齿表面更有可能从未储存的病变转变为声音？关于龋齿过渡时间，口腔中是否存在（左右或高低）对称性？磨牙比男孩更容易过渡到更高的疾病阶段 女孩们？从DDHP研究中分析Caries生命过程数据本质上是复杂的，这是由于间隔经过的观察结果，分层的口腔内相关性和多种龋齿状态 病变。统计文献中有几篇作品研究了相关的问题和并发症，但是这些作品通常只容纳其中一两个并发症。据我们所知，我们不知道任何同时解决所有这些并发症的统计模型。该项目专门旨在开发半参数多状态模型，用于在牙齿和牙齿表面水平上群群间隔进行的龋齿历史数据。并应用开发的模型来广泛分析DDHP研究的数据。从技术上讲，该方法将是从多状态模型的可能性中构建的，以进行间隔审查的观测以及惩罚的似然估计。该项目完成后，我们希望大大提高我们对低收入城市非裔美国人儿童幼儿龋齿的理解。最重要的是，获得的知识可能会促进这些服务不足的人群中未来对龋齿的预防和治疗。