Leveraging Electronic Dental Record Data for Clinical Research in the National Dental PBRN PracticesFunding This work was supported by National Institutes of Health grants U19-DE-28717 and U19-DE-22516. Opinions and assertions contained herein are those of the authors and are not to be construed as necessarily representing the views of the respective organizations or the National Institutes of Health.
05 November 2019
24 February 2020
29 April 2020 (online)
Objectives The aim of this study is to determine the feasibility of conducting clinical research using electronic dental record (EDR) data from U.S. solo and small-group general dental practices in the National Dental Practice-Based Research Network (network) and evaluate the data completeness and correctness before performing survival analyses of root canal treatment (RCT) and posterior composite restorations (PCR).
Methods Ninety-nine network general dentistry practices that used Dentrix or EagleSoft EDR shared de-identified data of patients who received PCR and/or RCT on permanent teeth through October 31, 2015. We evaluated the data completeness and correctness, summarized practice, and patient characteristics and summarized the two treatments by tooth type and arch location.
Results Eighty-two percent of practitioners were male, with a mean age of 49 and 22.4 years of clinical experience. The final dataset comprised 217,887 patients and 11,289,594 observations, with the observation period ranging from 0 to 37 years. Most patients (73%) were 18 to 64 years old; 56% were female. The data were nearly 100% complete. Eight percent of observations had incorrect data, such as incorrect tooth number or surface, primary teeth, supernumerary teeth, and tooth ranges, indicating multitooth procedures instead of PCR or RCT. Seventy-three percent of patients had dental insurance information; 27% lacked any insurance information. While gender was documented for all patients, race/ethnicity was missing in the dataset.
Conclusion This study established the feasibility of using EDR data integrated from multiple distinct solo and small-group network practices for longitudinal studies to assess treatment outcomes. The results laid the groundwork for a learning health system that enables practitioners to learn about their patients' outcomes by using data from their own practice.
An internet site devoted to details about the nation's network is located at http://NationalDentalPBRN.org. We are grateful to the network's regional node coordinators, who function as the “face” of the network in recruiting, training, and interacting with the network's practitioners (Midwest Region: T.S., RDH, BSDH; Western Region: Stephanie Hodge, MA; Northeast Region: Christine O'Brien, RDH; South Atlantic Region: Hanna Knopf, BA, and Deborah McEdward, RDH, BS, CCRP; South Central Region: Shermetria Massengale, MPH, CHES, and Ellen Sowell, BA; Southwest Region: Stephanie Reyes, BA, Meredith Buchberg, MPH, and Colleen Dolan, MPH), and the network's program manager (Andrea Mathews, BS, RDH), and program coordinator (Terri Jones).
Protection of Human and Animal Subjects
Our study was determined to be nonhuman subject research by the Indiana University Institutional Review Board (IRB). We also received IRB approvals or exemptions separately from the six Network regions: the Midwest, South Central, Southwest, Northeast, Western, and South Atlantic regions. The informed consent of all human subjects who participated in this investigation was obtained after the nature of the procedures had been explained fully.
* Dr. Thankam Paul Thyvalikakath and Dr. William D. Duncan are the first authors.
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