Biomedical subjects

A Jokovic

Publications and source records attributed to A Jokovic.

8 recordsLinked to original sources

PubMed1999

A cross-cultural study of oral health values.

The Oral Health Impact Profile (OHIP) is a measure of oral-health-related quality of life developed in Australia but being used increasingly in other populations. In view of the culturally specific nature of peoples' perceptions of health, if we are to make between-population comparisons of oral-health-related quality of life, cross-cultural equivalency of the relevant instruments needs to be verified. A study was therefore undertaken to compare item weights generated by an Australian sample with those generated by a sample of English-speaking Canadians and another of French-speaking Canadians. In addition, within-group comparisons by age were performed. The items and subscales used for the 2 Canadian samples were identical to those developed in Australia, although a formal French translation was used for the French-speaking sample. The method used for the generation of weights was Thurstone's paired-comparison technique, based on the judgments of convenience samples of subjects drawn from each of the three cultural settings. Comparisons were made by means of intra-subscale weight rankings and magnitude. Spearman's rank correlations of r> or =0.6 were found for 16/21 between-group comparisons and for 12/21, 19/21, and 8/21 within-group comparisons made by age in Australia, Ontario, and Quebec, respectively. Comparisons of the magnitudes of weights found that, even when items were ranked similarly, magnitudes could be quite different. These results suggest a reasonable degree of cross-cultural consistency, and hence validity, for the OHIP.

Adolescent↗

PubMed1998

Reducing variability in treatment decision-making: effectiveness of educating clinicians about uncertainty.

The objective of this study was to investigate whether or not education about the concept of uncertainty reduced variability in treatment decision-making. Three small groups of dentists in North York, Canada were asked to make restorative treatment decisions about simulated bitewing radiographs. They subsequently took part in a seminar about variations in perception and judgement and were given explanations of sensitivity, specificity and receiver operating characteristic (ROC) curve analysis. A repeat reading of the radiographs was then performed by both test and control groups. Results indicated that the intervention increased the accuracy, and decreased the variability of dentists' restorative treatment decisions. Kappa statistics were 0.33, 0.34 and 0.31 before the seminar, and 0.40, 0.43 and 0.41 after the seminar. Standard errors for kappas were 0.06, 0.05 and 0.05 before the seminar, and 0.02, 0.02 and 0.05 after the seminar. The area under the ROC curve was 0.7136 before the seminar and 0.7835 after the seminar. The data demonstrate that the dentists' decisions were less variable and more accurate following the educative intervention. This study suggests that there is potential for improving consistency and accuracy in clinical decision-making through education in probabilistic reasoning.

Adult↗

PubMed1997

Dissatisfaction with oral health status in an older adult population.

OBJECTIVES: The aim of this study was to assess dissatisfaction with oral health in an older adult population and to identify factors associated with dissatisfaction. METHODS: Data were obtained from 907 community-dwelling older adults aged 50 years and older using personal interviews and clinical examinations. Bivariate and multivariate analyses examined the relationships among dissatisfaction with oral health and a variety of sociodemographic variables, clinical oral health measures, and measures of the functional and psychosocial impact of oral disorders. RESULTS: Overall, 14.3 percent of respondents were dissatisfied with their ability to chew, 21.6 percent with their dental appearance, and 5.6 percent with their ability to speak clearly. Almost one-third (30.8%) were dissatisfied with at least one of these dimensions of oral health. Edentulous subjects were more likely to be dissatisfied than dentate subjects. The multivariate regression model for dentate subjects contained seven variables that explained 31 percent of the variance in dissatisfaction scores. For the edentulous, the model contained three variables that accounted for 53 percent of the variance. CONCLUSIONS: These results suggest that demographic, clinical, and psychosocial impact variables are associated with dissatisfaction with oral health. However, psychosocial impact variables had by far the strongest independent effect.

Aged↗

PubMed1997

Three-year changes in self-perceived oral health status in an older Canadian population.

Although change is a central goal of oral health care interventions, little attention has yet been paid to change in self-perceptions of oral health status. This is an important omission, given the current emphasis on assessing health outcomes. This paper reports the results of a study which examined changes over a period of three years in self-perceived oral health among 611 community-dwelling Canadians aged 50 years and over. Change in self-perceptions was measured by means of a global transition item and change scores derived from repeat administrations of four subjective oral health status indicators. Overall, 20.5% reported that their oral health had deteriorated over the three-year observation period, 68.5% that it had remained the same, and 10.5% that it had improved. There was a significant association between these global change categories and change scores for the four subjective indicators. Because of the small number of edentulous subjects, the analysis of baseline characteristics predicting change was confined to dentate subjects. Bivariate and logistic regression analyses were used to compare the two groups reporting change with those whose oral health status remained stable over the observation period. The results suggest that, when compared with this reference group, those who deteriorated and those who improved were similar in some respects but distinct in others. Those who improved appeared to have specific oral conditions at baseline causing pain. Those who deteriorated had poor oral health in general and came from more disadvantaged backgrounds. However, the explanatory power of logistic regression models predicting change in self-perceived oral health was poor when judged in terms of model sensitivities. This was to be expected, given that the models did not include variables documenting the incidence of disease, receipt of dental care, or changes in social and personal circumstances over the observation period.

Aged↗

PubMed1997

Life circumstances, lifestyles and oral health among older Canadians.

OBJECTIVE: To examine the contribution of life circumstances and lifestyles, and the interaction between them, to the oral health status of older Canadians. DESIGN: Subjects were recruited using a telephone interview survey, based on random digit dialling and subsequently interviewed and clinically examined. PARTICIPANTS: Four hundred and ninety-eight dentate subjects aged 53 years and over living independently in Ontario, Canada. MEASURES: Subjects were classified as living in deprived, middle or privileged life circumstances based on their social and personal attributes. They were also classified as having relatively poor or relatively favourable lifestyles based on their health behaviours. The oral health status indicators used were: the number of missing teeth, the number of decayed and filled root surfaces, mean periodontal attachment loss, the number of oral symptoms in the previous four weeks, self-rated oral health, and a psycho social impact score. RESULTS: In bivariate analyses, life circumstances were significantly associated with three of these six indicators and lifestyles with five. Healthy lifestyles had an effect on the oral health status of those living in deprived and middle circumstances but not on the privileged, although no overall interaction effect was observed in multivariate analyses controlling for gender and age. CONCLUSIONS: These data suggest that, among this population, life circumstances and lifestyles are both related to oral health. They also indicate that the role of these factors varies according to the condition and health indicator in question.

Age Factors↗

PubMed1997

The efficacy of nonopioid analgesics for postoperative dental pain: a meta-analysis.

The evidence for the efficacy of nonopioid analgesics in the dental pain model was examined by conducting a meta-analysis. Studies were obtained by searching the literature from August 1996 back to 1975 using the terms pain, analgesics, and dentistry. This led to the review of 294 articles, of which 33 studies met the inclusion criteria. Pain scale results were transformed into a common percent scale and converted to N-weighted means with differences in efficacy considered significant using a 95% confidence interval. Collectively, therapeutic doses of the nonsteroidal anti-inflammatory drugs (NSAIDs) commonly used in dentistry were significantly more efficacious than the combination of acetaminophen (600 or 650 mg) with codeine (60 mg). Similarly, specific doses of each of diflunisal, flurbiprofen, ibuprofen, and ketorolac were significantly more efficacious than the commonly used acetaminophen-codeine combination. These quantitative results show that particular NSAIDs may be more efficacious than the acetaminophen-codeine combination for relief of postoperative dental pain.

Acetaminophen↗

PubMed1996

Using subjective oral health status indicators to screen for dental care needs in older adults.

A study was undertaken to assess the ability of a number of subjective oral health status indicators to identify community-dwelling older adults who need dental treatment. The indicators consisted of a single-item self-rating of treatment need, a 15-item psychosocial impact index and the 49-item Oral Health Impact Profile (OHIP). Data for the study were collected as part of an oral health survey of Canadians aged 50 years and over. The associations between these subjective indicators and clinically defined dental treatment needs were assessed using statistics for determining the predictive power of a diagnostic test. Although there were statistically significant associations between the subjective and clinical measures, values for statistics such as sensitivity, positive predictive values and positive likelihood ratios were low. Although the measures did not perform well as screening tests, they did identify a sub-group of individuals whose clinical conditions impacted significantly on daily life and who would probably benefit the most from dental treatment. In this respect, the subjective measures assessed here can themselves be interpreted as indicators of need which complement conventional clinical measures of needs for dental care.

Activities of Daily Living↗

PubMed1996

Diagnostic tests.

Explore the source record for details and available documents.

Carcinoma, Squamous Cell↗