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Developing and Testing Electronic Health Record-Derived Caries Indices.

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A new tool, VERDICT, reliably calculates dental caries indices from electronic health records (EHRs). This innovation simplifies data collection for epidemiologic research and population oral health management.

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Area of Science:

  • Dental Public Health
  • Health Informatics
  • Epidemiology

Background:

  • Caries indices are crucial for epidemiologic research but challenging to obtain in clinical settings.
  • Electronic health records (EHRs) offer a potential data source, but automated extraction of caries indices is needed.

Purpose of the Study:

  • To design, test, and validate an automated program, VERDICT (Valid Electronic Health Record Dental Caries Indices Calculator Tool), for calculating caries indices from EHR data.
  • To assess the reliability and concordance of VERDICT-derived caries indices against established methods.

Main Methods:

  • VERDICT was developed to process EHR data for various dentition types and caries indices (e.g., DMFT/dmft, DMFS/dmfs).
  • Synthetic and actual patient EHR data were used for validation.
  • VERDICT measures were compared against a gold standard created using a validated clinical electronic data capture (EDC) system and statistical software (SAS).
  • Agreement statistics, including Lin's concordance coefficients (LCCs), were computed between VERDICT and human abstractors.

Main Results:

  • Extremely high concordance was observed between VERDICT and expert abstractors across multiple caries indices.
  • LCCs exceeded 0.99 for dmfs, dmft, and surface/tooth-specific indices.
  • LCCs were >0.95 for DMFS and DMFT, and 0.92-0.93 for MS and MT, indicating robust agreement.

Conclusions:

  • Caries indices can be reliably derived from EHRs using the VERDICT tool.
  • VERDICT facilitates the development of primary health outcome measures for research.
  • The tool supports population oral health management and quality improvement initiatives.