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Oral/dental items in the resident assessment instrument – minimum Data Set 2.0 lack validity: results of a retrospective, longitudinal validation study

Overview of attention for article published in Population Health Metrics, October 2016
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Title
Oral/dental items in the resident assessment instrument – minimum Data Set 2.0 lack validity: results of a retrospective, longitudinal validation study
Published in
Population Health Metrics, October 2016
DOI 10.1186/s12963-016-0108-y
Pubmed ID
Authors

Matthias Hoben, Jeffrey W. Poss, Peter G. Norton, Carole A. Estabrooks

Abstract

Oral health in nursing home residents is poor. Robust, mandated assessment tools such as the Resident Assessment Instrument - Minimum Data Set (RAI-MDS) 2.0 are key to monitoring and improving quality of oral health care in nursing homes. However, psychometric properties of RAI-MDS 2.0 oral/dental items have been challenged and criterion validity of these items has never been assessed. We used 73,829 RAI-MDS 2.0 records (13,118 residents), collected in a stratified random sample of 30 urban nursing homes in Western Canada (2007-2012). We derived a subsample of all residents (n = 2,711) with an admission and two or more subsequent annual assessments. Using Generalized Estimating Equations, adjusted for known covariates of nursing home residents' oral health, we assessed the association of oral/dental problems with time, dentate status, dementia, debris, and daily cleaning. Prevalence of oral/dental problems fluctuated (4.8 %-5.6 %) with no significant differences across time. This range of prevalence is substantially smaller than the ones reported by studies using clinical assessments by dental professionals. Denture wearers were less likely than dentate residents to have oral/dental problems (adjusted odds ratio [OR] = 0.458, 95 % confidence interval [CI]: 0.308, 0.680). Residents lacking teeth and not wearing dentures had higher odds than dentate residents of oral/dental problems (adjusted OR = 2.718, 95 % CI: 1.845, 4.003). Oral/dental problems were more prevalent in persons with debris (OR = 2.187, 95 % CI: 1.565, 3.057). Of the other variables assessed, only age at assessment was significantly associated with oral/dental problems. Robust, reliable RAI-MDS 2.0 oral health indicators are vital to monitoring and improving oral health related quality and safety in nursing homes. However, severe underdetection of oral/dental problems and lack of association of well-known oral health predictors with oral/dental problems suggest validity problems. Lacking teeth and not wearing dentures should be considered an indicator for urgent oral/dental treatment needs.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 119 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 119 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 20 17%
Student > Bachelor 13 11%
Researcher 11 9%
Student > Doctoral Student 10 8%
Student > Ph. D. Student 5 4%
Other 19 16%
Unknown 41 34%
Readers by discipline Count As %
Medicine and Dentistry 32 27%
Nursing and Health Professions 16 13%
Social Sciences 7 6%
Biochemistry, Genetics and Molecular Biology 5 4%
Economics, Econometrics and Finance 3 3%
Other 13 11%
Unknown 43 36%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 3. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 14 November 2016.
All research outputs
#13,407,768
of 22,896,955 outputs
Outputs from Population Health Metrics
#260
of 392 outputs
Outputs of similar age
#164,837
of 316,323 outputs
Outputs of similar age from Population Health Metrics
#7
of 13 outputs
Altmetric has tracked 22,896,955 research outputs across all sources so far. This one is in the 41st percentile – i.e., 41% of other outputs scored the same or lower than it.
So far Altmetric has tracked 392 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 13.7. This one is in the 33rd percentile – i.e., 33% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 316,323 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 47th percentile – i.e., 47% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 13 others from the same source and published within six weeks on either side of this one. This one is in the 38th percentile – i.e., 38% of its contemporaries scored the same or lower than it.