نوع مقاله : مقاله پژوهشی
نویسندگان
1 دانشجوی دکترا، گروه آمار زیستی، دانشکده پزشکی، دانشگاه علوم پزشکی شیراز، شیراز، ایران.
2 استاد، گروه آمار زیستی، دانشکده پزشکی، دانشگاه علوم پزشکی شیراز، شیراز، ایران.
3 دندان‌پزشک، گروه دندان‌پزشکی، دانشکده دندان‌پزشکی، دانشگاه علوم پزشکی لرستان، لرستان، ایران.
4 کارشناس ارشد، گروه اپیدمیولوژی و آمار زیستی، دانشکده بهداشت، دانشگاه علوم پزشکی سبزوار، سبزوار، ایران.
چکیده
اهداف بیماری‌های دهان در بیشتر جوامع شیوع دارند و پوسیدگی دندان شایع‌ترین بیماری مزمن درمیان کودکان و نوجوانان است. یکی از شاخص‌های پرکاربرد در مطالعات همه‌گیرشناسی مرتبط با دندان، شاخص DMFT است. در این مطالعه همه‌گیرشناسی پوسیدگی میان دانش‌آموزان بررسی شده و انواع مدل‌بندی DMFT با استفاده از داده واقعی مقایسه شده است.
مواد و روش ها این پژوهش حاصل مطالعه‌ای مقطعی طی سال‌های 1389 تا 1390 است که جامعه مطالعه‌شده در آن دانش‌آموزان 7 تا 12 ساله شهر خرم‌آباد در استان لرستان است که به روش نمونه‌گیری چندمرحله‌ای 920 نمونه انتخاب شدند. باتوجه‌به شمارشی‌بودن، چولگی به راست و انباشتگی صفر شاخص DMFT مدل‌های مختلف شامل رگرسیون پواسون، رگرسیون دوجمله‌ای منفی و رگرسیون پواسون متورم در صفر برای مدل‌بندی استفاده و انتخاب بهترین مدل براساس حداقل‌بودن مقدار AIC و BIC انجام شد. تجزیه‌وتحلیل داده‌ها با استفاده از ویرایش 12 نرم‌افزار Stata انجام و نتایج در سطح معناداری 05/0 گزارش شد.
یافته ها در این مطالعه 43درصد از دانش‌آموزان دختر و بقیه پسر بودند؛ به‌طوری‌که میانگین سن و DMFT آن‌ها به‌ترتیب 49/02±1/9 و 35/02±1/1 بود. 528 نفر از دانش‌آموزان پوسیدگی دندان داشتند. مدل رگرسیون پواسون متورم در صفر بهترین مدل از نظر نیکویی برازش درمقایسه‌با دیگر مدل‌ها بود. این مدل نشان داد که در سطح 05/0 رابطه معناداری بین سن، تحصیلات پدر و وجود پلاک میکروبی با درمعرض خطر پوسیدگی قرارگرفتن وجود دارد.
نتیجه گیری بهترین مدل بین مدل‌های استفاده‌شده در این تحقیق برای مدل‌بندی DMFT، رگرسیون پواسون متورم در صفر است. سن، تحصیلات پدر و وجود پلاک میکروبی با پوسیدگی دندان دانش‌آموزان مرتبط است.
کلیدواژه‌ها
عنوان مقاله [English]
Comparison of Several Count Regression Models on Modeling Decayed Missed Filled Teeth Dental Index in Dentistry
نویسندگان [English]
- Mehdi Birjandi 1
- Mohammad Salehi-Marzijarani 2
- Seyyed Mohammad Taghi Ayatollahi 3
- Houshang Rashidi 3
- Ali Hosseinzadeh 4
1 PhD Candidate, Department of Biostatistics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
2 PhD Candidate, Department of Biostatistics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
3 DMD, Department of Dentistry, School of Dentistry, Lorestan University of Medical Sciences, Lorestan, Iran.
4 MSc., Department of Epidemiology & Biostatistics, School of Public Health, Sabzevar University of Medical Sciences, Sabzevar, Iran.
چکیده [English]
Background Oral diseases are common in many communities and dental caries is the most prevalent disease among children and adults. DMFT (Decayed Missed Filled Teeth) is one of the useful indexes in dental epidemiology. This study aimed to investigate caries epidemiology among students and compare several modeling of DMFT based on real data.
Materials & Methods This cross-sectional study was conducted on school children aged 7-12 years in Khoramabad City, Iran during 2010 to 2011. A total of 920 samples were recruited by multistage random sampling method. Regarding to countable data, right skewness and zero inflated variable of DMFT index, different models such as Poisson regression, negative-binomial regression, and zero-inflated Poisson regression were used for modeling, and the selection of the best model was based on the minimum amount of AIC and BIC. Data analysis was performed using Stata version 12, according to significant level of 5%.
Results In this study, 43% of school children were girls and the rest were boys, so that their Mean±SD age and DMFT were 9.02±1.49 years and 1.02±1.35, respectively. A total of 528 (out of 920) children had dental caries. Zero-inflated Poisson regression, comparing with other models, was of the best model for goodness of fit among the fitted models. This model revealed significant relationships between being at risk of dental caries and variables of age, father’s educational level, and presence of microbial plaque (P<0.05). Severity of dental caries intensified significantly as children’s ages increased (P<0.05).
Conclusion The best regression method for modeling DMFT among all models in this study was zero-inflated Poisson regression. Age, father’s educational level, and presence of microbial plaque were significantly correlated with children’s dental caries.
کلیدواژه‌ها [English]
- Dental epidemiology
- Dental caries
- Poisson regression
- DMFT index
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