Performance of Self‐Reported Measures for Periodontitis in Rheumatoid Arthritis and Osteoarthritis. Issue 1 (1st January 2015)

• Record Type: Journal Article
• Authors: Coburn, Brian W.; Sayles, Harlan R.; Payne, Jeffrey B.; Redman, Robert S.; Markt, Jeffery C.; Beatty, Mark W.; Griffiths, Garth R.; McGowan, David J.; Mikuls, Ted R.
• Is Part Of: Journal of periodontology. Volume 86:Issue 1(2015)
• Page Start: 16
• Page End: 26
• Publication Date: 2015-01-01
• Subjects: Arthritis, rheumatoid -- osteoarthritis -- periodontitis -- rheumatoid factor -- self report -- sensitivity and specificity; Periodontics -- Periodicals; 617.632
• DOI: 10.1902/jop.2014.140339
• Languages: English
• ISSNs: 0022-3492

Abstract

Abstract : Background: This study evaluates the performance of self‐report against the reference standard of clinically defined periodontitis in patients with rheumatoid arthritis (RA) and osteoarthritis (OA) after accounting for factors associated with periodontitis. Methods: Six self‐report periodontitis questions were evaluated in patients with RA and OA. Questions were validated against a reference standard of severe and moderate‐to‐severe periodontitis based on full‐mouth examination. Multivariable logistic regression was used to evaluate the performance of: 1) self‐report alone; 2) age, sex, education, and smoking status; and 3) a combination of the above. Model performance was assessed using the c‐statistic. Convergent validity of self‐reported "bone loss/deep pockets" and "loose teeth" was assessed; associations of self‐report with RA disease characteristics were explored. Results: Self‐report performed similarly in RA and OA, with individual question specificity for periodontitis ≥68% and sensitivity from 9.8% to 45%. Question‐only models yielded c ‐statistics of 0.66 to 0.72, whereas risk factor–only models yielded c ‐statistics of 0.74 to 0.79. The highest‐performing models incorporated both self‐report questions and periodontitis risk factors, with c ‐statistics ≥0.79. Greater radiographic alveolar bone loss was observed among participants reporting "bone loss/deep pockets" ( P <0.001) and "loose teeth" ( P <0.001). Among patients with RA, "loose teeth, " but not other self‐report items, was associated with rheumatoid factor positivity ( P = 0.047) and higher disease activity ( P <0.001). Conclusions: Patient self‐report, when combined with other risk factors, performs well in identifying periodontitis among patients with RA and OA. Self‐report questions related to alveolar bone loss exhibit excellent convergent validity in these patient subsets.