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 Wöstmann; Stefan Wolfart; Florentine Jahn

doi:10.1016/j.jebdp.2022.101794

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

Oral Medicine and Diagnosis

Research output: Contribution to journal › Article › peer-review

4 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 language	English (US)
Article number	101794
Journal	Journal of Evidence-Based Dental Practice
Volume	23
Issue number	1
DOIs	https://doi.org/10.1016/j.jebdp.2022.101794
State	Published - 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

Publisher link

10.1016/j.jebdp.2022.101794License: CC BY

Find It

Find It at U of M Libraries

Cite this

Schierz, O., lee, C. H., John, M. T., Rauch, A., Reissmann, D. R., Kohal, R., Marrè, B., Böning, K., Walter, M. H., Luthardt, R. G., 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), Article 101794. https://doi.org/10.1016/j.jebdp.2022.101794

Schierz, O, lee, CH, John, MT, Rauch, A, Reissmann, DR, Kohal, R, Marrè, B, Böning, K, Walter, MH, Luthardt, RG, Rudolph, H, Mundt, T, Hannak, W, Heydecke, G, Kern, M, Hartmann, S, Boldt, J, Stark, H, Edelhoff, D, Wöstmann, B, Wolfart, S & 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, vol. 23, no. 1, 101794. https://doi.org/10.1016/j.jebdp.2022.101794

@article{f1cc3ca09fe54ff7b40bfbb833fd482f,

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

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{\textquoteright} OHRQoL improved substantially and stayed primarily stable over the 15 years. Non-responders{\textquoteright} 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.",

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

author = "Oliver Schierz and lee, {Chi Hyun} and John, {Mike T.} and Angelika Rauch and Reissmann, {Daniel R.} and Ralf Kohal and Birgit Marr{\`e} and Klaus B{\"o}ning and Walter, {Michael H.} and Luthardt, {Ralph Gunnar} and Heike Rudolph and Torsten Mundt and Wolfgang Hannak and Guido Heydecke and Matthias Kern and Sinsa Hartmann and Julian Boldt and Helmut Stark and Daniel Edelhoff and Bernd W{\"o}stmann and Stefan Wolfart and Florentine Jahn",

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 f{\"u}r Prothetische Zahnmedizin und Biomaterialien e.V., DGPro), and the German Society of Dentistry and Oral Medicine (Deutsche Gesellschaft f{\"u}r 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 f{\"u}r Prothetische Zahnmedizin und Biomaterialien e.V., DGPro), and the German Society of Dentistry and Oral Medicine (Deutsche Gesellschaft f{\"u}r Zahn-, Mund- und Kieferheilkunde, DGZMK). Publisher Copyright: {\textcopyright} 2022 The Author(s)",

year = "2023",

month = jan,

doi = "10.1016/j.jebdp.2022.101794",

language = "English (US)",

volume = "23",

journal = "Journal of Evidence-Based Dental Practice",

issn = "1532-3382",

publisher = "Mosby Inc.",

number = "1",

}

TY - JOUR

T1 - HOW TO IDENTIFY SUBGROUPS IN LONGITUDINAL CLINICAL DATA

T2 - TREATMENT RESPONSE PATTERNS IN PATIENTS WITH A SHORTENED DENTAL ARCH

AU - Schierz, Oliver

AU - lee, Chi Hyun

AU - John, Mike T.

AU - Rauch, Angelika

AU - Reissmann, Daniel R.

AU - Kohal, Ralf

AU - Marrè, Birgit

AU - Böning, Klaus

AU - Walter, Michael H.

AU - Luthardt, Ralph Gunnar

AU - Rudolph, Heike

AU - Mundt, Torsten

AU - Hannak, Wolfgang

AU - Heydecke, Guido

AU - Kern, Matthias

AU - Hartmann, Sinsa

AU - Boldt, Julian

AU - Stark, Helmut

AU - Edelhoff, Daniel

AU - Wöstmann, Bernd

AU - Wolfart, Stefan

AU - Jahn, Florentine

N1 - 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)

PY - 2023/1

Y1 - 2023/1

N2 - 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.

AB - 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.

KW - Developmental trajectories

KW - Non-responder analysis

KW - Oral health-related quality of life

KW - Partially dentate adults

KW - Randomized clinical trial

KW - Tooth loss

UR - http://www.scopus.com/inward/record.url?scp=85145681043&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85145681043&partnerID=8YFLogxK

U2 - 10.1016/j.jebdp.2022.101794

DO - 10.1016/j.jebdp.2022.101794

M3 - Article

C2 - 36707170

AN - SCOPUS:85145681043

SN - 1532-3382

VL - 23

JO - Journal of Evidence-Based Dental Practice

JF - Journal of Evidence-Based Dental Practice

IS - 1

M1 - 101794

ER -

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

Abstract

Bibliographical note

Keywords

PubMed: MeSH publication types

Publisher link

Find It

Other files and links

Fingerprint

Cite this