Verification of a questionnaire for screening of gum disease in a medical setting

ISRCTN ISRCTN12098039
DOI https://doi.org/10.1186/ISRCTN12098039
Secondary identifying numbers 2019.267
Submission date
13/01/2020
Registration date
31/01/2020
Last edited
11/02/2022
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Oral Health
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English Summary

Background and study aims
Periodontitis is often known as 'Gum Disease' and is a very common condition in which the gums and deeper periodontal structures become inflamed.
In a previous project from our research group, a self-reported oral health questionnaire to screen for periodontitis was validated a rapid and non-invasive screening tool for periodontitis was developed. The tool is eventually to be used in medical settings where oral examinations for periodontitis are not feasible. Before this screening tool can be implemented on a large scale, it also requires external validation. In other words, we need to assess its performance in a medical patient population other than the one used for the development. Once externally validated against a routine clinical periodontitis screening, our screening tool could support, for example, diabetes care providers to screen fort periodontitis and with that to adhere to the medical guidelines and recommendations without the need of an oral examination.
The main objective of this study is to externally validate a screening tool for periodontitis, based on a self-reported oral health questionnaire and patient demographics (sex, age, smoking, ethnicity, education level, number of yearly dental visits).

Who can participate?
Patients aged 18 – 80 years, with at least one of their own teeth

What does the study involve?
Patients will be examined using the new screening tool and the standard method when they attend clinic.

What are the possible benefits and risks of participating?
It is likely that there will be no noticeable advantages for the patients. However, it is possible that the routine oral examination (the screening for periodontitis) reveals periodontal problems that had been unnoticed until that point. If so, the patient is immediately notified, and it is recommended to visit his/her dentist. If this results in early diagnosis and treatment of periodontitis by the dentist, this will have positive effects on oral health and possible also systemic health of the patient.

All oral examinations and measurements are non-invasive and fast (The Dutch Periodontal Screening index, 5 minutes); there are no risks for the patient, except perhaps in some situations there will be a short-lived discomfort. The DPSI measurements take place during the already planned appointment at the outpatient internal medicine policlinic (UMC, location AMC). Other than the additional time that is required for this study (approximately 3 minutes for filling in the questionnaire and 5 mins for the DPSI), there are no disadvantages for participating in the study.

Where is the study run from?
UMC, location AMC Amsterdam, The Netherlands

When is the study starting and how long is it expected to run for?
September 2019 to March 2020

Who is funding the study?
Investigator initiated and funded

Who is the main contact?
Prof B.G. Loos
b.loos@acta.nl

Contact information

Prof B.G. Loos
Scientific

ACTA (Academic Center of Dentistry Amsterdam)
Departement of Periodontology:
Gustav Mahlerlaan 3004
Amsterdam
1081 LA
Netherlands

ORCiD logoORCID ID 0000-0002-8794-552X
Phone +31 20 5980322
Email b.loos@acta.nl

Study information

Study designObservational cross-sectional study
Primary study designObservational
Secondary study designCross sectional study
Study setting(s)Hospital
Study typeScreening
Participant information sheet Not available in web format, please use the contact details below to request a patient information sheet
Scientific titleValidation of a questionnaire for rapid, non-invasive screening of periodontitis in a medical care setting
Study acronymPERIOSCREEN
Study hypothesisThe primary purpose of this present study was to perform an external validation of the rapid non-invasive screening tool for periodontitis as developed by Verhulst et al. (2019). It will be investigated whether this screening tool model is valid outside the ACTA clinics.
Ethics approval(s)Approved 12/07/2019, Medical Ethical Committee of the UMC, location VU Medical Center (VUmc) (BS7, room H-443, Postbus 7057, 1007 MB Amsterdam; +31 20 44 45585; metc@vumc.nl), ref: 2019.267
ConditionPeriodontitis
InterventionWithin one week before a clinical visit to a medical doctor (internist, outpatient internal medicine clinics UMC (University Medical Center), location AMC (Academic Medical Center) Amsterdam), all planned patients will receive an information letter about the current ongoing study. When waiting in the waiting room, researcher 1 will ask the patient to participate. If the patient approves to participate, he/she is taken into the research room.

First researcher 1, the SROH (Self-Reported Oral Health) questionnaire is conducted, which will take about 3 minutes.

Second, researcher 2 performs the periodontal examination (periodontitis screening by the Dutch Periodontal Screening Index [DPSI]) and informs the patient about whether he/she is suspected to have periodontitis (DPSI category C); the periodontal examination will take about 5 minutes. Therefore the research will take 8 minutes total.

Finally, the remaining data of the GH questionnaire such as BMI, blood pressure, HbA1c, LDL-, HDL- and total cholesterol level, triglycerides, eGFR, albumin and creatinine concentration, medication and diseases are obtained through EPIC, the electronic health record of the UMC.
Intervention typeOther
Primary outcome measure1. DPSI (measured by one of the researchers): periodontitis yes/no
2. SROH questionnaire (done by one of the researchers and calculated by a formula): suspected to have periodontitis yes/no’
3. Model performance parameters: sensitivity, specificity, NPV, PPV and AURROC
Secondary outcome measuresObtained through EPIC, the electronic health record of the UMC:
1. BMI (kg/m²)
2. Blood pressure (mmHg)
3. HbA1c, LDL-, HDL- and total cholesterol level
4. Triglycerides
5. eGFR
6. Albumin and creatinine concentration
7. Demographic factors (age, ethnicity and education level)
Overall study start date01/01/2019
Overall study end date01/07/2020

Eligibility

Participant type(s)Patient
Age groupMixed
SexBoth
Target number of participants200
Total final enrolment159
Participant inclusion criteria1. Patients from 18 - 80 years of age
2. All ethnicities
3. All sexes
4. All education levels
5. At least one of their own teeth
6. Patients under control to an internist at the internal medicine clinic (UMC, location AMC)
Participant exclusion criteria1. Edentulous (with or without full dentures (regardless of dental implant support)
2. Do not speak Dutch or English
3. Patients who were not present in EPIC (the electronic health record of the UMC)
Recruitment start date01/09/2019
Recruitment end date01/04/2020

Locations

Countries of recruitment

  • Netherlands

Study participating centre

UMC location AMC Amsterdam
Meibergdreef 9
Amsterdam
1105 AZ
Netherlands

Sponsor information

Academic Center for Dentistry Amsterdam
Hospital/treatment centre

Gustav Mahlerlaan 3004
Amsterdam
1081 LA
Netherlands

Phone +31 20 598 0380
Email info@acta.nl
Website https://www.acta.nl/nl/
ROR logo "ROR" https://ror.org/04x5wnb75

Funders

Funder type

Other

Investigator initiated and funded

No information available

Results and Publications

Intention to publish date01/09/2020
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryStored in repository
Publication and dissemination planPlanned publication in a high-impact peer-reviewed journal.
IPD sharing planThe datasets generated during and/or analysed during the current study will be stored in a publically available repository (Figshare). The data will be offered upon request to Prof. dr. B.G. Loos. Email: b.loos@acta.nl. Type of data: SPSS data file. Data is available from: after successful publication in a peer-reviewed journal for 10 years. Access criteria: academic researchers and joined publications. Patients did sign informed consent. Data is anonymous and can only be connected to the participant by the main investigators.

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Protocol file version v4.0 11/06/2019 05/02/2020 No No
Results article 01/12/2021 11/02/2022 Yes No

Additional files

ISRCTN12098039_PROTOCOL_v4.0_11Jun19.pdf
uploaded 05/02/2020

Editorial Notes

11/02/2022: Publication reference and total final enrolment added.
05/02/2020: Uploaded protocol (not peer reviewed) as an additional file.
22/01/2020: Trial’s existence confirmed by Medical Ethical Committee of the UMC, Amsterdam.