Journal article

Authors list: Schierz, Oliver; Lee, Chi Hyun; John, Mike T.; Rauch, Angelika; Reissmann, Daniel R.; Kohal, Ralf; Marre, Birgit; Boening, Klaus; Walter, Michael H.; Luthardt, Ralph Gunnar; Rudolph, Heike; Mundt, Torsten; Hannak, Wolfgang; Heydecke, Guido; Kern, Matthias; Hartmann, Sinsa; Boldt, Julian; Stark, Helmut; Edelhoff, Daniel; Woestmann, Bernd; Wolfart, Stefan; Jahn, Florentine

Publication year: 2023

Journal: Journal of Evidence-Based Dental Practice

Volume number: 23

Issue number: 1

ISSN: 1532-3382

eISSN: 1532-3390

Open access status: Hybrid

DOI Link: https://doi.org/10.1016/j.jebdp.2022.101794

Publisher: Elsevier

Abstract: 
Background When dental patients seek care, treatments are not always successful,that is pa-tients' oral health problems are not always eliminated or substantially reduced. Identifying these patients (treatment non-responders) is essential for clinical decision-making. Group-based trajectory modeling (GBTM) is rarely used in den-tistry, but a promising statistical technique to identify non-responders in particu-lar and clinical distinct patient groups in general in longitudinal data sets. Aim Using group-based trajectory modeling, this study aimed to demonstrate how to identify oral health-related quality of life (OHRQoL) treatment response patterns by the example of patients with a shortened dental arch (SDA). Methods This paper is a secondary data analysis of a randomized controlled clinical trial. In this trial SDA patients received partial removable dental prostheses replacing missing teeth up to the first molars (N = 79) either or the dental arch ended with the second premolar that was present or replaced by a cantilever fixed dental prosthesis (N = 71). Up to ten follow-up examinations (1-2, 6, 12, 24, 36, 48, 60, 96, 120, and 180 months post-treatment) continued for 15 years. The outcomeOHRQoL was assessed with the 49-item Oral Health Impact Profile (OHIP). Ex-ploratory GBTM was performed to identify treatment response patterns. Results Two response patterns could be identified - "responders" and "non-responders." Responders' OHRQoL improved substantially and stayed primarily stable over the 15 years. Non-responders' OHRQoL did not improve considerably over time or worsened. While the SDA treatments were not related to the 2 response patterns, higher levels of functional, pain-related, psychological im-pairment in particular, and severely impaired OHRQoL in general predicted a non-responding OHRQoL pattern after treatment. Supplementary, a 3 pattern approach has been evaluated. Conclusions Clustering patients according to certain longitudinal characteristics after treatment is generally important, but specifically identifying treatment in non-responders is central. With the increasing availability of OHRQoL data in clinical research and regular patient care, GBTM has become a powerful tool to investi-gate which dental treatment works for which patients.

Harvard Citation style: Schierz, O., Lee, C., John, M., Rauch, A., Reissmann, D., Kohal, R., et al. (2023) HOW TO IDENTIFY SUBGROUPS IN LONGITUDINAL CLINICAL DATA: TREATMENT RESPONSE PATTERNS IN PATIENTS WITH A SHORTENED DENTAL ARCH, Journal of Evidence-Based Dental Practice, 23(1). https://doi.org/10.1016/j.jebdp.2022.101794

APA Citation style: Schierz, O., Lee, C., John, M., Rauch, A., Reissmann, D., Kohal, R., Marre, B., Boening, K., Walter, M., Luthardt, R., Rudolph, H., Mundt, T., Hannak, W., Heydecke, G., Kern, M., Hartmann, S., Boldt, J., Stark, H., Edelhoff, D., ...Jahn, F. (2023). HOW TO IDENTIFY SUBGROUPS IN LONGITUDINAL CLINICAL DATA: TREATMENT RESPONSE PATTERNS IN PATIENTS WITH A SHORTENED DENTAL ARCH. Journal of Evidence-Based Dental Practice. 23(1). https://doi.org/10.1016/j.jebdp.2022.101794