Data Quality of Caries Indices in an Electronic Health Record

Objectives: The objective of this study was to assess how well validated automatic electronic health record (EHR) derived caries indices correlate with dental clinician observed findings.
Methods: Patients who scheduled comprehensive or periodic oral examinations were recruited from the general dentistry faculty and resident clinic (n=81). Two dentists from the Faculty Group Practice and three from the AEGD resident clinic were recruited for this study. They were categorized into two groups: F for Faculty Group Practice and A for AEGD clinic (IRB #15-16296, Implementing Dental Quality Measures in Practice). Subjects received a complete clinical examination by their provider. The Valid electronic health record dental caries indices calculator tool (VERDICT) algorithm determined caries indices (White J, et. al. Developing and Testing Electronic Health Record-Derived Caries Indices. Caries Research, 2019, doi:10.1159/000499700). A trained, calibrated assessor performed a clinical examination for 10 caries indices (DMFT, DMFS, DT, MT, FT, DS, MS, FS, number of teeth and surfaces) and a manual comparison using the VERDICT calculator tool was performed in the EHR. Any discrepancies in ratings between the two methods on any of the ten measures were noted and the correlation between methodologies by each of the caries indices was determined using Lin's concordance correlation coefficient.
Results: LCCs for F+A caries indices: DMFT, DMFS, MT, FT, DS, MS, FS had correlations above 0.900, which indicates excellent correlation. Permanent surfaces had a correlation between 0.750 and 0.900, which indicates good correlation. DT had a correlation between 0.500 and 0.750, which indicates moderate correlation.
Conclusions: Data quality from VERDICT caries indices captured from an electronic health record correlates well with examination findings and can be used for clinical and research purposes.