HOW TO IDENTIFY SUBGROUPS IN LONGITUDINAL CLINICAL DATA: TREATMENT RESPONSE PATTERNS IN PATIENTS WITH A SHORTENED DENTAL ARCH

Oliver Schierz, Chi Hyun lee, Mike T. John, Angelika Rauch, Daniel R. Reissmann, Ralf Kohal, Birgit Marrè, Klaus Böning, Michael H. Walter, Ralph Gunnar Luthardt, Heike Rudolph, Torsten Mundt, Wolfgang Hannak, Guido Heydecke, Matthias Kern, Sinsa Hartmann, Julian Boldt, Helmut Stark, Daniel Edelhoff, Bernd WöstmannStefan Wolfart, Florentine Jahn

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Background: When dental patients seek care, treatments are not always successful,that is patients' 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 dentistry, but a promising statistical technique to identify non-responders in particular 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 outcome OHRQoL was assessed with the 49-item Oral Health Impact Profile (OHIP). Exploratory 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 impairment 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 investigate which dental treatment works for which patients.

Original languageEnglish (US)
Article number101794
JournalJournal of Evidence-Based Dental Practice
Volume23
Issue number1
DOIs
StatePublished - Jan 2023

Bibliographical note

Funding Information:
SOURCE OF FUNDING: This study was supported by the German Research Foundation (Deutsche Forschungsgemeinschaft, DFG) grant DFG WA 831/2–1 to 2–6, grant DFG WO 677/2–1.1 to 2–2.1, grant WA 831/3–1 and grant Lu 723/8–1. During the course of the study, further funding was acquired through Cendres & Metaux SA (grant Nr. 0442–11), the German Association for Prosthetic Dental Medicine and Biomaterials (Deutsche Gesellschaft für Prothetische Zahnmedizin und Biomaterialien e.V., DGPro), and the German Society of Dentistry and Oral Medicine (Deutsche Gesellschaft für Zahn-, Mund- und Kieferheilkunde, DGZMK).

Funding Information:
SOURCE OF FUNDING: This study was supported by the German Research Foundation (Deutsche Forschungsgemeinschaft, DFG) grant DFG WA 831/2–1 to 2–6 , grant DFG WO 677/2–1.1 to 2–2.1 , grant WA 831/3–1 and grant Lu 723/8–1 . During the course of the study, further funding was acquired through Cendres & Metaux SA (grant Nr. 0442–11 ), the German Association for Prosthetic Dental Medicine and Biomaterials (Deutsche Gesellschaft für Prothetische Zahnmedizin und Biomaterialien e.V., DGPro), and the German Society of Dentistry and Oral Medicine (Deutsche Gesellschaft für Zahn-, Mund- und Kieferheilkunde, DGZMK).

Publisher Copyright:
© 2022 The Author(s)

Keywords

  • Developmental trajectories
  • Non-responder analysis
  • Oral health-related quality of life
  • Partially dentate adults
  • Randomized clinical trial
  • Tooth loss

PubMed: MeSH publication types

  • Randomized Controlled Trial
  • Journal Article
  • Research Support, Non-U.S. Gov't

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