Multilevel model to estimate county-level untreated dental caries among US children aged 6–9years using the National Health and Nutrition Examination Survey
Because conducting population-based oral health screening is resource intensive, oral health data at small-area levels (e.g., county-level) are not commonly available. We applied the multilevel logistic regression and poststratification method to estimate county-level prevalence of untreated dental...
Ausführliche Beschreibung
Gespeichert in:
| Autor*in: |
Lin, Mei [verfasserIn] |
|---|
| Format: |
E-Artikel |
|---|---|
| Sprache: |
Englisch |
| Erschienen: |
2018transfer abstract |
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| Umfang: |
8 |
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| Übergeordnetes Werk: |
Enthalten in: Impaired central coherence in patients with anorexia nervosa - Hamatani, Sayo ELSEVIER, 2017, an international journal devoted to practice and theory, Amsterdam |
|---|---|
| Übergeordnetes Werk: |
volume:111 ; year:2018 ; pages:291-298 ; extent:8 |
| Links: |
|---|
| DOI / URN: |
10.1016/j.ypmed.2017.11.015 |
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ELV042862795 |
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| 245 | 1 | 0 | |a Multilevel model to estimate county-level untreated dental caries among US children aged 6–9years using the National Health and Nutrition Examination Survey |
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| 520 | |a Because conducting population-based oral health screening is resource intensive, oral health data at small-area levels (e.g., county-level) are not commonly available. We applied the multilevel logistic regression and poststratification method to estimate county-level prevalence of untreated dental caries among children aged 6–9years in the United States using data from the National Health and Nutrition Examination Survey (NHANES) 2005–2010 linked with various area-level data at census tract, county and state levels. We validated model-based national estimates against direct estimates from NHANES. We also compared model-based estimates with direct estimates from select State Oral Health Surveys (SOHS) at state and county levels. The model with individual-level covariates only and the model with individual-, census tract- and county-level covariates explained 7.2% and 96.3% respectively of overall county-level variation in untreated caries. Model-based county-level prevalence estimates ranged from 4.9% to 65.2% with median of 22.1%. The model-based national estimate (19.9%) matched the NHANES direct estimate (19.8%). We found significantly positive correlations between model-based estimates for 8-year-olds and direct estimates from the third-grade State Oral Health Surveys (SOHS) at state level for 34 states (Pearson coefficient: 0.54, P =0.001) and SOHS estimates at county level for 53 New York counties (Pearson coefficient: 0.38, P =0.006). This methodology could be a useful tool to characterize county-level disparities in untreated dental caries among children aged 6–9years and complement oral health surveillance to inform public health programs especially when local-level data are not available although the lack of external validation due to data unavailability should be acknowledged. | ||
| 520 | |a Because conducting population-based oral health screening is resource intensive, oral health data at small-area levels (e.g., county-level) are not commonly available. We applied the multilevel logistic regression and poststratification method to estimate county-level prevalence of untreated dental caries among children aged 6–9years in the United States using data from the National Health and Nutrition Examination Survey (NHANES) 2005–2010 linked with various area-level data at census tract, county and state levels. We validated model-based national estimates against direct estimates from NHANES. We also compared model-based estimates with direct estimates from select State Oral Health Surveys (SOHS) at state and county levels. The model with individual-level covariates only and the model with individual-, census tract- and county-level covariates explained 7.2% and 96.3% respectively of overall county-level variation in untreated caries. Model-based county-level prevalence estimates ranged from 4.9% to 65.2% with median of 22.1%. The model-based national estimate (19.9%) matched the NHANES direct estimate (19.8%). We found significantly positive correlations between model-based estimates for 8-year-olds and direct estimates from the third-grade State Oral Health Surveys (SOHS) at state level for 34 states (Pearson coefficient: 0.54, P =0.001) and SOHS estimates at county level for 53 New York counties (Pearson coefficient: 0.38, P =0.006). This methodology could be a useful tool to characterize county-level disparities in untreated dental caries among children aged 6–9years and complement oral health surveillance to inform public health programs especially when local-level data are not available although the lack of external validation due to data unavailability should be acknowledged. | ||
| 700 | 1 | |a Zhang, Xingyou |4 oth | |
| 700 | 1 | |a Holt, James B. |4 oth | |
| 700 | 1 | |a Robison, Valerie |4 oth | |
| 700 | 1 | |a Li, Chien-Hsun |4 oth | |
| 700 | 1 | |a Griffin, Susan O. |4 oth | |
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10.1016/j.ypmed.2017.11.015 doi /cbs_pica/cbs_olc/import_discovery/elsevier/einzuspielen/GBV00000000001002.pica (DE-627)ELV042862795 (ELSEVIER)S0091-7435(17)30456-5 DE-627 ger DE-627 rakwb eng 610 VZ 44.91 bkl Lin, Mei verfasserin aut Multilevel model to estimate county-level untreated dental caries among US children aged 6–9years using the National Health and Nutrition Examination Survey 2018transfer abstract 8 nicht spezifiziert zzz rdacontent nicht spezifiziert z rdamedia nicht spezifiziert zu rdacarrier Because conducting population-based oral health screening is resource intensive, oral health data at small-area levels (e.g., county-level) are not commonly available. We applied the multilevel logistic regression and poststratification method to estimate county-level prevalence of untreated dental caries among children aged 6–9years in the United States using data from the National Health and Nutrition Examination Survey (NHANES) 2005–2010 linked with various area-level data at census tract, county and state levels. We validated model-based national estimates against direct estimates from NHANES. We also compared model-based estimates with direct estimates from select State Oral Health Surveys (SOHS) at state and county levels. The model with individual-level covariates only and the model with individual-, census tract- and county-level covariates explained 7.2% and 96.3% respectively of overall county-level variation in untreated caries. Model-based county-level prevalence estimates ranged from 4.9% to 65.2% with median of 22.1%. The model-based national estimate (19.9%) matched the NHANES direct estimate (19.8%). We found significantly positive correlations between model-based estimates for 8-year-olds and direct estimates from the third-grade State Oral Health Surveys (SOHS) at state level for 34 states (Pearson coefficient: 0.54, P =0.001) and SOHS estimates at county level for 53 New York counties (Pearson coefficient: 0.38, P =0.006). This methodology could be a useful tool to characterize county-level disparities in untreated dental caries among children aged 6–9years and complement oral health surveillance to inform public health programs especially when local-level data are not available although the lack of external validation due to data unavailability should be acknowledged. Because conducting population-based oral health screening is resource intensive, oral health data at small-area levels (e.g., county-level) are not commonly available. We applied the multilevel logistic regression and poststratification method to estimate county-level prevalence of untreated dental caries among children aged 6–9years in the United States using data from the National Health and Nutrition Examination Survey (NHANES) 2005–2010 linked with various area-level data at census tract, county and state levels. We validated model-based national estimates against direct estimates from NHANES. We also compared model-based estimates with direct estimates from select State Oral Health Surveys (SOHS) at state and county levels. The model with individual-level covariates only and the model with individual-, census tract- and county-level covariates explained 7.2% and 96.3% respectively of overall county-level variation in untreated caries. Model-based county-level prevalence estimates ranged from 4.9% to 65.2% with median of 22.1%. The model-based national estimate (19.9%) matched the NHANES direct estimate (19.8%). We found significantly positive correlations between model-based estimates for 8-year-olds and direct estimates from the third-grade State Oral Health Surveys (SOHS) at state level for 34 states (Pearson coefficient: 0.54, P =0.001) and SOHS estimates at county level for 53 New York counties (Pearson coefficient: 0.38, P =0.006). This methodology could be a useful tool to characterize county-level disparities in untreated dental caries among children aged 6–9years and complement oral health surveillance to inform public health programs especially when local-level data are not available although the lack of external validation due to data unavailability should be acknowledged. Zhang, Xingyou oth Holt, James B. oth Robison, Valerie oth Li, Chien-Hsun oth Griffin, Susan O. oth Enthalten in Elsevier Hamatani, Sayo ELSEVIER Impaired central coherence in patients with anorexia nervosa 2017 an international journal devoted to practice and theory Amsterdam (DE-627)ELV000729329 volume:111 year:2018 pages:291-298 extent:8 https://doi.org/10.1016/j.ypmed.2017.11.015 Volltext GBV_USEFLAG_U GBV_ELV SYSFLAG_U SSG-OLC-PHA 44.91 Psychiatrie Psychopathologie VZ AR 111 2018 291-298 8 |
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10.1016/j.ypmed.2017.11.015 doi /cbs_pica/cbs_olc/import_discovery/elsevier/einzuspielen/GBV00000000001002.pica (DE-627)ELV042862795 (ELSEVIER)S0091-7435(17)30456-5 DE-627 ger DE-627 rakwb eng 610 VZ 44.91 bkl Lin, Mei verfasserin aut Multilevel model to estimate county-level untreated dental caries among US children aged 6–9years using the National Health and Nutrition Examination Survey 2018transfer abstract 8 nicht spezifiziert zzz rdacontent nicht spezifiziert z rdamedia nicht spezifiziert zu rdacarrier Because conducting population-based oral health screening is resource intensive, oral health data at small-area levels (e.g., county-level) are not commonly available. We applied the multilevel logistic regression and poststratification method to estimate county-level prevalence of untreated dental caries among children aged 6–9years in the United States using data from the National Health and Nutrition Examination Survey (NHANES) 2005–2010 linked with various area-level data at census tract, county and state levels. We validated model-based national estimates against direct estimates from NHANES. We also compared model-based estimates with direct estimates from select State Oral Health Surveys (SOHS) at state and county levels. The model with individual-level covariates only and the model with individual-, census tract- and county-level covariates explained 7.2% and 96.3% respectively of overall county-level variation in untreated caries. Model-based county-level prevalence estimates ranged from 4.9% to 65.2% with median of 22.1%. The model-based national estimate (19.9%) matched the NHANES direct estimate (19.8%). We found significantly positive correlations between model-based estimates for 8-year-olds and direct estimates from the third-grade State Oral Health Surveys (SOHS) at state level for 34 states (Pearson coefficient: 0.54, P =0.001) and SOHS estimates at county level for 53 New York counties (Pearson coefficient: 0.38, P =0.006). This methodology could be a useful tool to characterize county-level disparities in untreated dental caries among children aged 6–9years and complement oral health surveillance to inform public health programs especially when local-level data are not available although the lack of external validation due to data unavailability should be acknowledged. Because conducting population-based oral health screening is resource intensive, oral health data at small-area levels (e.g., county-level) are not commonly available. We applied the multilevel logistic regression and poststratification method to estimate county-level prevalence of untreated dental caries among children aged 6–9years in the United States using data from the National Health and Nutrition Examination Survey (NHANES) 2005–2010 linked with various area-level data at census tract, county and state levels. We validated model-based national estimates against direct estimates from NHANES. We also compared model-based estimates with direct estimates from select State Oral Health Surveys (SOHS) at state and county levels. The model with individual-level covariates only and the model with individual-, census tract- and county-level covariates explained 7.2% and 96.3% respectively of overall county-level variation in untreated caries. Model-based county-level prevalence estimates ranged from 4.9% to 65.2% with median of 22.1%. The model-based national estimate (19.9%) matched the NHANES direct estimate (19.8%). We found significantly positive correlations between model-based estimates for 8-year-olds and direct estimates from the third-grade State Oral Health Surveys (SOHS) at state level for 34 states (Pearson coefficient: 0.54, P =0.001) and SOHS estimates at county level for 53 New York counties (Pearson coefficient: 0.38, P =0.006). This methodology could be a useful tool to characterize county-level disparities in untreated dental caries among children aged 6–9years and complement oral health surveillance to inform public health programs especially when local-level data are not available although the lack of external validation due to data unavailability should be acknowledged. Zhang, Xingyou oth Holt, James B. oth Robison, Valerie oth Li, Chien-Hsun oth Griffin, Susan O. oth Enthalten in Elsevier Hamatani, Sayo ELSEVIER Impaired central coherence in patients with anorexia nervosa 2017 an international journal devoted to practice and theory Amsterdam (DE-627)ELV000729329 volume:111 year:2018 pages:291-298 extent:8 https://doi.org/10.1016/j.ypmed.2017.11.015 Volltext GBV_USEFLAG_U GBV_ELV SYSFLAG_U SSG-OLC-PHA 44.91 Psychiatrie Psychopathologie VZ AR 111 2018 291-298 8 |
| allfields_unstemmed |
10.1016/j.ypmed.2017.11.015 doi /cbs_pica/cbs_olc/import_discovery/elsevier/einzuspielen/GBV00000000001002.pica (DE-627)ELV042862795 (ELSEVIER)S0091-7435(17)30456-5 DE-627 ger DE-627 rakwb eng 610 VZ 44.91 bkl Lin, Mei verfasserin aut Multilevel model to estimate county-level untreated dental caries among US children aged 6–9years using the National Health and Nutrition Examination Survey 2018transfer abstract 8 nicht spezifiziert zzz rdacontent nicht spezifiziert z rdamedia nicht spezifiziert zu rdacarrier Because conducting population-based oral health screening is resource intensive, oral health data at small-area levels (e.g., county-level) are not commonly available. We applied the multilevel logistic regression and poststratification method to estimate county-level prevalence of untreated dental caries among children aged 6–9years in the United States using data from the National Health and Nutrition Examination Survey (NHANES) 2005–2010 linked with various area-level data at census tract, county and state levels. We validated model-based national estimates against direct estimates from NHANES. We also compared model-based estimates with direct estimates from select State Oral Health Surveys (SOHS) at state and county levels. The model with individual-level covariates only and the model with individual-, census tract- and county-level covariates explained 7.2% and 96.3% respectively of overall county-level variation in untreated caries. Model-based county-level prevalence estimates ranged from 4.9% to 65.2% with median of 22.1%. The model-based national estimate (19.9%) matched the NHANES direct estimate (19.8%). We found significantly positive correlations between model-based estimates for 8-year-olds and direct estimates from the third-grade State Oral Health Surveys (SOHS) at state level for 34 states (Pearson coefficient: 0.54, P =0.001) and SOHS estimates at county level for 53 New York counties (Pearson coefficient: 0.38, P =0.006). This methodology could be a useful tool to characterize county-level disparities in untreated dental caries among children aged 6–9years and complement oral health surveillance to inform public health programs especially when local-level data are not available although the lack of external validation due to data unavailability should be acknowledged. Because conducting population-based oral health screening is resource intensive, oral health data at small-area levels (e.g., county-level) are not commonly available. We applied the multilevel logistic regression and poststratification method to estimate county-level prevalence of untreated dental caries among children aged 6–9years in the United States using data from the National Health and Nutrition Examination Survey (NHANES) 2005–2010 linked with various area-level data at census tract, county and state levels. We validated model-based national estimates against direct estimates from NHANES. We also compared model-based estimates with direct estimates from select State Oral Health Surveys (SOHS) at state and county levels. The model with individual-level covariates only and the model with individual-, census tract- and county-level covariates explained 7.2% and 96.3% respectively of overall county-level variation in untreated caries. Model-based county-level prevalence estimates ranged from 4.9% to 65.2% with median of 22.1%. The model-based national estimate (19.9%) matched the NHANES direct estimate (19.8%). We found significantly positive correlations between model-based estimates for 8-year-olds and direct estimates from the third-grade State Oral Health Surveys (SOHS) at state level for 34 states (Pearson coefficient: 0.54, P =0.001) and SOHS estimates at county level for 53 New York counties (Pearson coefficient: 0.38, P =0.006). This methodology could be a useful tool to characterize county-level disparities in untreated dental caries among children aged 6–9years and complement oral health surveillance to inform public health programs especially when local-level data are not available although the lack of external validation due to data unavailability should be acknowledged. Zhang, Xingyou oth Holt, James B. oth Robison, Valerie oth Li, Chien-Hsun oth Griffin, Susan O. oth Enthalten in Elsevier Hamatani, Sayo ELSEVIER Impaired central coherence in patients with anorexia nervosa 2017 an international journal devoted to practice and theory Amsterdam (DE-627)ELV000729329 volume:111 year:2018 pages:291-298 extent:8 https://doi.org/10.1016/j.ypmed.2017.11.015 Volltext GBV_USEFLAG_U GBV_ELV SYSFLAG_U SSG-OLC-PHA 44.91 Psychiatrie Psychopathologie VZ AR 111 2018 291-298 8 |
| allfieldsGer |
10.1016/j.ypmed.2017.11.015 doi /cbs_pica/cbs_olc/import_discovery/elsevier/einzuspielen/GBV00000000001002.pica (DE-627)ELV042862795 (ELSEVIER)S0091-7435(17)30456-5 DE-627 ger DE-627 rakwb eng 610 VZ 44.91 bkl Lin, Mei verfasserin aut Multilevel model to estimate county-level untreated dental caries among US children aged 6–9years using the National Health and Nutrition Examination Survey 2018transfer abstract 8 nicht spezifiziert zzz rdacontent nicht spezifiziert z rdamedia nicht spezifiziert zu rdacarrier Because conducting population-based oral health screening is resource intensive, oral health data at small-area levels (e.g., county-level) are not commonly available. We applied the multilevel logistic regression and poststratification method to estimate county-level prevalence of untreated dental caries among children aged 6–9years in the United States using data from the National Health and Nutrition Examination Survey (NHANES) 2005–2010 linked with various area-level data at census tract, county and state levels. We validated model-based national estimates against direct estimates from NHANES. We also compared model-based estimates with direct estimates from select State Oral Health Surveys (SOHS) at state and county levels. The model with individual-level covariates only and the model with individual-, census tract- and county-level covariates explained 7.2% and 96.3% respectively of overall county-level variation in untreated caries. Model-based county-level prevalence estimates ranged from 4.9% to 65.2% with median of 22.1%. The model-based national estimate (19.9%) matched the NHANES direct estimate (19.8%). We found significantly positive correlations between model-based estimates for 8-year-olds and direct estimates from the third-grade State Oral Health Surveys (SOHS) at state level for 34 states (Pearson coefficient: 0.54, P =0.001) and SOHS estimates at county level for 53 New York counties (Pearson coefficient: 0.38, P =0.006). This methodology could be a useful tool to characterize county-level disparities in untreated dental caries among children aged 6–9years and complement oral health surveillance to inform public health programs especially when local-level data are not available although the lack of external validation due to data unavailability should be acknowledged. Because conducting population-based oral health screening is resource intensive, oral health data at small-area levels (e.g., county-level) are not commonly available. We applied the multilevel logistic regression and poststratification method to estimate county-level prevalence of untreated dental caries among children aged 6–9years in the United States using data from the National Health and Nutrition Examination Survey (NHANES) 2005–2010 linked with various area-level data at census tract, county and state levels. We validated model-based national estimates against direct estimates from NHANES. We also compared model-based estimates with direct estimates from select State Oral Health Surveys (SOHS) at state and county levels. The model with individual-level covariates only and the model with individual-, census tract- and county-level covariates explained 7.2% and 96.3% respectively of overall county-level variation in untreated caries. Model-based county-level prevalence estimates ranged from 4.9% to 65.2% with median of 22.1%. The model-based national estimate (19.9%) matched the NHANES direct estimate (19.8%). We found significantly positive correlations between model-based estimates for 8-year-olds and direct estimates from the third-grade State Oral Health Surveys (SOHS) at state level for 34 states (Pearson coefficient: 0.54, P =0.001) and SOHS estimates at county level for 53 New York counties (Pearson coefficient: 0.38, P =0.006). This methodology could be a useful tool to characterize county-level disparities in untreated dental caries among children aged 6–9years and complement oral health surveillance to inform public health programs especially when local-level data are not available although the lack of external validation due to data unavailability should be acknowledged. Zhang, Xingyou oth Holt, James B. oth Robison, Valerie oth Li, Chien-Hsun oth Griffin, Susan O. oth Enthalten in Elsevier Hamatani, Sayo ELSEVIER Impaired central coherence in patients with anorexia nervosa 2017 an international journal devoted to practice and theory Amsterdam (DE-627)ELV000729329 volume:111 year:2018 pages:291-298 extent:8 https://doi.org/10.1016/j.ypmed.2017.11.015 Volltext GBV_USEFLAG_U GBV_ELV SYSFLAG_U SSG-OLC-PHA 44.91 Psychiatrie Psychopathologie VZ AR 111 2018 291-298 8 |
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10.1016/j.ypmed.2017.11.015 doi /cbs_pica/cbs_olc/import_discovery/elsevier/einzuspielen/GBV00000000001002.pica (DE-627)ELV042862795 (ELSEVIER)S0091-7435(17)30456-5 DE-627 ger DE-627 rakwb eng 610 VZ 44.91 bkl Lin, Mei verfasserin aut Multilevel model to estimate county-level untreated dental caries among US children aged 6–9years using the National Health and Nutrition Examination Survey 2018transfer abstract 8 nicht spezifiziert zzz rdacontent nicht spezifiziert z rdamedia nicht spezifiziert zu rdacarrier Because conducting population-based oral health screening is resource intensive, oral health data at small-area levels (e.g., county-level) are not commonly available. We applied the multilevel logistic regression and poststratification method to estimate county-level prevalence of untreated dental caries among children aged 6–9years in the United States using data from the National Health and Nutrition Examination Survey (NHANES) 2005–2010 linked with various area-level data at census tract, county and state levels. We validated model-based national estimates against direct estimates from NHANES. We also compared model-based estimates with direct estimates from select State Oral Health Surveys (SOHS) at state and county levels. The model with individual-level covariates only and the model with individual-, census tract- and county-level covariates explained 7.2% and 96.3% respectively of overall county-level variation in untreated caries. Model-based county-level prevalence estimates ranged from 4.9% to 65.2% with median of 22.1%. The model-based national estimate (19.9%) matched the NHANES direct estimate (19.8%). We found significantly positive correlations between model-based estimates for 8-year-olds and direct estimates from the third-grade State Oral Health Surveys (SOHS) at state level for 34 states (Pearson coefficient: 0.54, P =0.001) and SOHS estimates at county level for 53 New York counties (Pearson coefficient: 0.38, P =0.006). This methodology could be a useful tool to characterize county-level disparities in untreated dental caries among children aged 6–9years and complement oral health surveillance to inform public health programs especially when local-level data are not available although the lack of external validation due to data unavailability should be acknowledged. Because conducting population-based oral health screening is resource intensive, oral health data at small-area levels (e.g., county-level) are not commonly available. We applied the multilevel logistic regression and poststratification method to estimate county-level prevalence of untreated dental caries among children aged 6–9years in the United States using data from the National Health and Nutrition Examination Survey (NHANES) 2005–2010 linked with various area-level data at census tract, county and state levels. We validated model-based national estimates against direct estimates from NHANES. We also compared model-based estimates with direct estimates from select State Oral Health Surveys (SOHS) at state and county levels. The model with individual-level covariates only and the model with individual-, census tract- and county-level covariates explained 7.2% and 96.3% respectively of overall county-level variation in untreated caries. Model-based county-level prevalence estimates ranged from 4.9% to 65.2% with median of 22.1%. The model-based national estimate (19.9%) matched the NHANES direct estimate (19.8%). We found significantly positive correlations between model-based estimates for 8-year-olds and direct estimates from the third-grade State Oral Health Surveys (SOHS) at state level for 34 states (Pearson coefficient: 0.54, P =0.001) and SOHS estimates at county level for 53 New York counties (Pearson coefficient: 0.38, P =0.006). This methodology could be a useful tool to characterize county-level disparities in untreated dental caries among children aged 6–9years and complement oral health surveillance to inform public health programs especially when local-level data are not available although the lack of external validation due to data unavailability should be acknowledged. Zhang, Xingyou oth Holt, James B. oth Robison, Valerie oth Li, Chien-Hsun oth Griffin, Susan O. oth Enthalten in Elsevier Hamatani, Sayo ELSEVIER Impaired central coherence in patients with anorexia nervosa 2017 an international journal devoted to practice and theory Amsterdam (DE-627)ELV000729329 volume:111 year:2018 pages:291-298 extent:8 https://doi.org/10.1016/j.ypmed.2017.11.015 Volltext GBV_USEFLAG_U GBV_ELV SYSFLAG_U SSG-OLC-PHA 44.91 Psychiatrie Psychopathologie VZ AR 111 2018 291-298 8 |
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multilevel model to estimate county-level untreated dental caries among us children aged 6–9years using the national health and nutrition examination survey |
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Multilevel model to estimate county-level untreated dental caries among US children aged 6–9years using the National Health and Nutrition Examination Survey |
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Because conducting population-based oral health screening is resource intensive, oral health data at small-area levels (e.g., county-level) are not commonly available. We applied the multilevel logistic regression and poststratification method to estimate county-level prevalence of untreated dental caries among children aged 6–9years in the United States using data from the National Health and Nutrition Examination Survey (NHANES) 2005–2010 linked with various area-level data at census tract, county and state levels. We validated model-based national estimates against direct estimates from NHANES. We also compared model-based estimates with direct estimates from select State Oral Health Surveys (SOHS) at state and county levels. The model with individual-level covariates only and the model with individual-, census tract- and county-level covariates explained 7.2% and 96.3% respectively of overall county-level variation in untreated caries. Model-based county-level prevalence estimates ranged from 4.9% to 65.2% with median of 22.1%. The model-based national estimate (19.9%) matched the NHANES direct estimate (19.8%). We found significantly positive correlations between model-based estimates for 8-year-olds and direct estimates from the third-grade State Oral Health Surveys (SOHS) at state level for 34 states (Pearson coefficient: 0.54, P =0.001) and SOHS estimates at county level for 53 New York counties (Pearson coefficient: 0.38, P =0.006). This methodology could be a useful tool to characterize county-level disparities in untreated dental caries among children aged 6–9years and complement oral health surveillance to inform public health programs especially when local-level data are not available although the lack of external validation due to data unavailability should be acknowledged. |
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Because conducting population-based oral health screening is resource intensive, oral health data at small-area levels (e.g., county-level) are not commonly available. We applied the multilevel logistic regression and poststratification method to estimate county-level prevalence of untreated dental caries among children aged 6–9years in the United States using data from the National Health and Nutrition Examination Survey (NHANES) 2005–2010 linked with various area-level data at census tract, county and state levels. We validated model-based national estimates against direct estimates from NHANES. We also compared model-based estimates with direct estimates from select State Oral Health Surveys (SOHS) at state and county levels. The model with individual-level covariates only and the model with individual-, census tract- and county-level covariates explained 7.2% and 96.3% respectively of overall county-level variation in untreated caries. Model-based county-level prevalence estimates ranged from 4.9% to 65.2% with median of 22.1%. The model-based national estimate (19.9%) matched the NHANES direct estimate (19.8%). We found significantly positive correlations between model-based estimates for 8-year-olds and direct estimates from the third-grade State Oral Health Surveys (SOHS) at state level for 34 states (Pearson coefficient: 0.54, P =0.001) and SOHS estimates at county level for 53 New York counties (Pearson coefficient: 0.38, P =0.006). This methodology could be a useful tool to characterize county-level disparities in untreated dental caries among children aged 6–9years and complement oral health surveillance to inform public health programs especially when local-level data are not available although the lack of external validation due to data unavailability should be acknowledged. |
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Because conducting population-based oral health screening is resource intensive, oral health data at small-area levels (e.g., county-level) are not commonly available. We applied the multilevel logistic regression and poststratification method to estimate county-level prevalence of untreated dental caries among children aged 6–9years in the United States using data from the National Health and Nutrition Examination Survey (NHANES) 2005–2010 linked with various area-level data at census tract, county and state levels. We validated model-based national estimates against direct estimates from NHANES. We also compared model-based estimates with direct estimates from select State Oral Health Surveys (SOHS) at state and county levels. The model with individual-level covariates only and the model with individual-, census tract- and county-level covariates explained 7.2% and 96.3% respectively of overall county-level variation in untreated caries. Model-based county-level prevalence estimates ranged from 4.9% to 65.2% with median of 22.1%. The model-based national estimate (19.9%) matched the NHANES direct estimate (19.8%). We found significantly positive correlations between model-based estimates for 8-year-olds and direct estimates from the third-grade State Oral Health Surveys (SOHS) at state level for 34 states (Pearson coefficient: 0.54, P =0.001) and SOHS estimates at county level for 53 New York counties (Pearson coefficient: 0.38, P =0.006). This methodology could be a useful tool to characterize county-level disparities in untreated dental caries among children aged 6–9years and complement oral health surveillance to inform public health programs especially when local-level data are not available although the lack of external validation due to data unavailability should be acknowledged. |
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