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. 2019 Apr;4(2):143-150.
doi: 10.1177/2380084418815150. Epub 2018 Dec 8.

Utilization and Validity of the Dental Diagnostic System over Time in Academic and Private Practice

A Yansane  1 , O Tokede  2 , J White  1 , J Etolue  2 , L McClellan  3 , M Walji  4 , E Obadan-Udoh  1 , E Kalenderian  1
Affiliations

Utilization and Validity of the Dental Diagnostic System over Time in Academic and Private Practice

A Yansane et al. JDR Clin Trans Res. 2019 Apr.

Abstract

Introduction: To fill the void created by insufficient dental terminologies, a multi-institutional workgroup was formed among members of the Consortium for Oral Health Research and Informatics to develop the Dental Diagnostic System (DDS) in 2009. The adoption of dental diagnosis terminologies by providers must be accompanied by rigorous usability and validity assessments to ensure their effectiveness in practice.

Objectives: The primary objective of this study was to describe the utilization and correct use of the DDS over a 4-y period.

Methods: Electronic health record data were amassed from 2013 to 2016 where diagnostic terms and Current Dental Terminology procedure code pairs were adjudicated by calibrated dentists. With the resultant data, we report on the 4-y utilization and validity of the DDS at 5 dental institutions. Utilization refers to the proportion of instances that diagnoses are documented in a structured format, and validity is defined as the frequency of valid pairs divided by the number of all treatment codes entered.

Results: Nearly 10 million procedures ( n = 9,946,975) were documented at the 5 participating institutions between 2013 and 2016. There was a 1.5-fold increase in the number of unique diagnoses documented during the 4-y period. The utilization and validity proportions of the DDS had statistically significant increases from 2013 to 2016 ( P < 0.0001). Academic dental sites were more likely to document diagnoses associated with orthodontic and restorative procedures, while the private dental site was equally likely to document diagnoses associated with all procedures. Overall, the private dental site had significantly higher utilization and validity proportions than the academic dental sites.

Conclusion: The results demonstrate an improvement in utilization and validity of the DDS terminology over time. These findings also yield insight into the factors that influence the usability, adoption, and validity of dental terminologies, raising the need for more focused training of dental students.

Knowledge transfer statement: Ensuring that providers use standardized methods for documentation of diagnoses represents a challenge within dentistry. The results of this study can be used by clinicians when evaluating the utility of diagnostic terminologies embedded within the electronic health record.

Keywords: clinic management; dental education; dentistry; diagnostic terminology; electronic health record; standardized diagnostic terms.

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Conflict of interest statement

The authors declare no potential conflicts of interest with respect to the authorship and/or publication of this article.

Figures

Figure 1.
Figure 1.
Frequency of unique diagnoses by year and dental site.
Figure 2.
Figure 2.
Utilization proportions over time in academic and private dental sites.
Figure 3.
Figure 3.
Utilization proportions by Current Dental Terminology categories in academic and private dental sites.
Figure 4.
Figure 4.
Validity proportions over time in academic and private dental sites.
Figure 5.
Figure 5.
Validity proportions by Current Dental Terminology categories in academic and private dental sites.
See this image and copyright information in PMC

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