Title: Assessing the Utilization and Validity of the Dental Diagnostic System
Alfa Yansane (Presenter)
University of California at San Francisco
Bunmi Tokede, Harvard University
Joel White, University of California - San Francisco
Jini Etolue, Harvard School of Dental Medicine
Muhammad Walji, The University of Texas Health Science Center at Houston, School of Dentistry
Enihomo Obadan-Udoh, University of California San Francisco School of Dentistry
Elsbeth Kalenderian, University of California, San Francisco School of Dentistry
Objectives: To fill the void created by insufficient dental terminologies, a multi-institutional workgroup was formed among members of the Consortium for Oral Health-Related Informatics (COHRI) to develop the Dental Diagnostic System (DDS) in 2009. While the development of a usable dental diagnosis terminology and its adoption by dental care providers are paramount, rigorous assessments of the use and validity of any terminology must be done to assure its effectiveness in practice.
Methods: Electronic health records data was amassed from 2013 to 2016 where diagnostic terms and CDT procedure code pairs were adjudicated by calibrated dentists. With the resultant data, we report on the four-year utilization and validity of the DDS at four academic, dental institutions. The utilization refers to the proportion of instances that diagnoses are documented in a structured format and the validity is defined as the frequency of valid pairs divided by the number of all treatment codes entered.
Results: Over 2 million procedures were performed at the four participating institutions between 2013 and 2016. There was a 1.8 fold increase in the number of unique diagnoses used during the two year period. The utilization proportions were 70.2% (95% CI: 70.0, 70.5) in 2013 and 89.2% (95% CI: 88.9.2, 90.0) in 2016 and the validity proportions were 73.0% (95% CI: 72.3, 73.1) in 2013 and 79.4% (95% CI: 79.2, 79.6) in 2016, each of which represents a statistically significant increase over the four-year period (p<0.0001). There were significant differences in the utilization and validity proportions across dental schools and CDT categories.
Conclusions: The results demonstrate an improvement in utilization and valid use of the DDS terminology over time. These findings also yield insight into the factors which influence use and validity, raising the need for more focused training of dental providers.