How to identify subgroups in longitudinal clinical data: Treatment response patterns in patients with a shortened dental arch

Schierz, Oliver; Lee, Chi Hyun; John, Mike T.; Rauch, Angelika; Reissmann, Daniel R.; Kohal, Ralf; Marre, Birgit; Boening, Klaus; Walter, Michael H.; Gunnar, Ralph; Rudolph, Heike; Mundt, Torsten; Hannak, Wolfgang; Heydecke, Guido; Kern, Matthias; Hartmann, Sinsa; Boldt, Julian; Stark, Helmut; Edelhoff, Daniel; Woestmann, Bernd; Wolfart, Stefan und Jahn, Florentine (2022): How to identify subgroups in longitudinal clinical data: Treatment response patterns in patients with a shortened dental arch. In: Journal of Evidence-Based Dental Practice, Bd. 23, Nr. SUPPL 1: S. 1-14

Abstract

BackgroundWhen 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.AimUsing 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).MethodsThis 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). Ex-ploratory GBTM was performed to identify treatment response patterns. ResultsTwo 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 consider-ably over time or worsened. While the SDA treatments were not related to the 2 response patterns, higher levels of functional, pain-related, psychological im-pairment in particular, and severely impaired OHRQoL in general predicted a non-responding OHRQoL pattern after treatment. Supplementary, a 3 pattern approach has been evaluated.ConclusionsClustering patients according to certain longitudinal characteristics after treat-ment 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 investi-gate which dental treatment works for which patients.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 1532-3382
• Sprache: Englisch