Diagnostic Accuracy of Self-Reported Questionnaires for Detecting Periodontitis Across Multiple Cultures and Geographic Locations: A Systematic Review and Meta-Analysis

IF 6.8 1区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Clinical Periodontology Pub Date : 2025-08-08 DOI:10.1111/jcpe.70002

Mengning Bi, Yu Xie, Xiaoyu Yu, Hairui Li, Yuan Li, Maurizio S. Tonetti

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引用次数: 0

Abstract

Objective

To evaluate self-reported questionnaires' intrinsic validity and diagnostic accuracy for detecting periodontitis across diverse cultural and geographic contexts.

Materials and Methods

Electronic searches were conducted in PubMed, Embase and the Cochrane Library until 4 March 2025. Studies included those using the Centers for Disease Control and Prevention and the American Academy of Periodontology (CDC/AAP) criteria or the 2017 World Workshop classifications as reference standards and reporting the diagnostic accuracy of self-reported questionnaire items. The validity of the eight-item questionnaire developed by the CDC/AAP was assessed by analysing the proportion of answers, and bias was evaluated using the QUADAS-2 tool. Owing to the limited number of studies using the 2017 World Workshop classifications, the quantitative synthesis was restricted to those using the CDC/AAP criteria. Sensitivity, specificity, diagnostic odds ratio (DOR) and 95% confidence intervals (CIs) were calculated for total periodontitis (including mild, moderate and severe cases), moderate-to-severe periodontitis and severe periodontitis.

Results

Totally, 23 studies (from 22 articles) were included in the systematic review, with 16 studies (from 15 articles) eligible for meta-analysis. The ‘Don't know/Refused’ option across the eight items of the CDC/AAP questionnaire ranged from 0% to 46.1%, indicating variable comprehension of certain items. Pooled sensitivity and specificity across the questionnaire items ranged from 17% to 82% and from 23% to 97%, respectively. DOR varied from 0.75 (95% CI: 0.54–1.03) to 8.01 (95% CI: 2.33–27.45). Significant heterogeneity was observed for most questions.

Conclusions

Self-reported questionnaires show potential for monitoring periodontitis but face issues with sensitivity and cross-cultural validity. Future research should focus on culturally adaptive designs and standardised validation protocols to enhance diagnostic accuracy and improve their effectiveness in global periodontal health screening.

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查看原文本刊更多论文

不同文化和地理位置的牙周炎自我报告问卷的诊断准确性：系统回顾和荟萃分析。

目的评价不同文化和地理背景下牙周炎患者自我报告问卷的内在效度和诊断准确性。材料与方法在PubMed， Embase和Cochrane图书馆进行电子检索，直到2025年3月4日。研究包括使用疾病控制与预防中心和美国牙周病学会（CDC/AAP）标准或2017年世界研讨会分类作为参考标准，并报告自我报告问卷项目的诊断准确性。CDC/AAP开发的8项问卷通过分析回答比例来评估效度，并使用QUADAS-2工具评估偏倚。由于使用2017年世界研讨会分类的研究数量有限，定量综合仅限于使用CDC/AAP标准的研究。计算全牙周炎（包括轻度、中度和重度病例）、中重度牙周炎和重度牙周炎的敏感性、特异性、诊断优势比（DOR）和95%置信区间（ci）。结果系统评价共纳入23项研究（来自22篇文章），其中16项研究（来自15篇文章）符合meta分析。在CDC/AAP问卷的8个项目中，“不知道/拒绝”选项从0%到46.1%不等，表明对某些项目的理解程度不一。问卷项目的综合敏感性和特异性分别为17%至82%和23%至97%。DOR从0.75 （95% CI: 0.54-1.03）到8.01 （95% CI: 2.33-27.45）不等。在大多数问题上观察到显著的异质性。结论自述问卷具有监测牙周炎的潜力，但存在敏感性和跨文化有效性问题。未来的研究应侧重于文化适应性设计和标准化验证方案，以提高诊断准确性并提高其在全球牙周健康筛查中的有效性。

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来源期刊

Journal of Clinical Periodontology 医学-牙科与口腔外科

CiteScore

13.30

自引率

10.40%

发文量

175

审稿时长

3-8 weeks

期刊介绍： Journal of Clinical Periodontology was founded by the British, Dutch, French, German, Scandinavian, and Swiss Societies of Periodontology. The aim of the Journal of Clinical Periodontology is to provide the platform for exchange of scientific and clinical progress in the field of Periodontology and allied disciplines, and to do so at the highest possible level. The Journal also aims to facilitate the application of new scientific knowledge to the daily practice of the concerned disciplines and addresses both practicing clinicians and academics. The Journal is the official publication of the European Federation of Periodontology but wishes to retain its international scope. The Journal publishes original contributions of high scientific merit in the fields of periodontology and implant dentistry. Its scope encompasses the physiology and pathology of the periodontium, the tissue integration of dental implants, the biology and the modulation of periodontal and alveolar bone healing and regeneration, diagnosis, epidemiology, prevention and therapy of periodontal disease, the clinical aspects of tooth replacement with dental implants, and the comprehensive rehabilitation of the periodontal patient. Review articles by experts on new developments in basic and applied periodontal science and associated dental disciplines, advances in periodontal or implant techniques and procedures, and case reports which illustrate important new information are also welcome.