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Examination

survey

Diagnosis

analysis

Treatment planning

program planning

Treatment

program operation

Payment

finance

Evaluation

evaluation/appraisal

WHO

international, world health organization

DHHS

dept of health and human services, Healthy people 2020, federal

CDC

centers for disease control and prevention, federal

HRSA

health resources and services administration, federal

NIDCR

national institute of dental and craniofacial research, federal

AHRQ

agency for healthcare research and quality, federal

Random sampling

each element in the population has an equal chance of appearing; reduces chance of bias

Stratified sampling

selecting an element according to certain subgroups to diminish the change of sample flucuation; can be random stratified- accomplished by randomly selecting a proportionate number of subjects from each subgroup for the sample

Systematic sampling

select every "nth" to participate

Judgement sampling

someone who knows the population selects the sample; familiarity with the population, bias introduced

Convenience sampling

group is chosen because it happens to be convenient; may represent the population; ease for evaluator

Variable

what is being measured or observed

Dependent variable

the outcome of interest; should change in response to intervention

Independent variable

the intervention; what is being manipulated

Statistics

a science that describes data for the purpose of making interpretations

Descriptive statistics

concerned with the presentation, organization, and summarization of the data

Inferential statistics

allows one to generalize from the sample to a larger group of subjects

Frequency distribution

tabulating how often each score occurs

Ungrouped

data is presented in ascending or descending order along with the frequency of each score occuring in the data set

Cumulative

frequency of occurance of scores up to and including any given value in the data set

Grouped

grouping variables into consecutive intervals

Skew

symmetry of the curve

Positive skew

more scores are in the lower range

Negative skew

more scores are in the higher range

Normal curve

bell, gaussian, scores are equally distributed around the mean; meand, median, and mode all have the same value

Measures of central tendency

different ways to define the center or middle of a distribution

Mean

average number of scores; add all scores and divide by number of scores; most common measure of central tendency

Median

divides the distribution into 2 equal parts; 50% of scores lie above center, 50% of scores lie below center, not affected by extreme scores

Mode

score that occurs with greatest frequency; corresponds to the peak of the curve when plotted out

Measures of dispersion

describes how wide the scores are around a central point

Range

difference between the high and low score; affected by extremely high or low scores

Standard deviation

the square root of the sample variance; most commonly uesd method of dispersion, the larger the number representing the SD, the wider the distribution curve

Validity

the degree to which a data collection instrument measures the variable it is designed to measure; does the test really measure what it claims to be measuring?

Reliability

the extent to which the method of measurement performs consistently

Intraexaminer

consistent performance by the same investigator when using a data collection instrument

Interexaminer

consistent performance by different investigators when using the same data collection instrument

Calibration

the process of establishing a relationship between a measuring device and the units of measure; helps increase interexaminer reliability

Sensitivity

the ability of a test to correctly identify the presence of a disease

Specificity

the ability of a test to correctly identify the absence of a disease

Correlation co-efficient

determines the strength of relationship between 2 variables; shows a possible cause and effect; between -1 & +1; the closer to either of those numbers the stronger the correlation

Positive correlation

direct association betwen 2 variables; as value of x increases, the value of y increases; as the value of x decreases, the value of y decreases

Negative correlation

the score on one scale predicts an opposite score on the other scale; as the value of x increases, the value of y decreases; as the value of x decreases, the value of y increases

T-test

a statistical hypothesis test used when comparing the statistical difference between 2 mean scores

ANOVA

analysis of variance, used when comparing the statistical difference between 3 or more mean scores

P-value

probability value, used when testing hypothesis; standard of acceptability is p less than or equal to 0.05, 1 out of 20 occured by chance, nothing to do with the testing situation

Primary preventive services

involves techniques and agents to forestall onset and reverse progress of disease or arrest the disease profess before treatment becomes necessary. Ex: mechanical and chemical plaque removal, fluoride, sugar discipline

Secondary preventive services

involves routine treatment methods to terminate a disease and restore tissues to as normal as possible; intervene or prevent the progression and recurrence of disease. Ex: periodontal debridement, restorations

Tertiary preventive services

involves measures necessary to replace lost tissue and rehabilitate patients. Ex: prosthestics, implants

Epidemic

an unexpectedly large number of cases of disease in a particular population at a particular place and time.

Endemic

a disease that occurs regularly in a population as a matter of course

Pandemic

an outbreak of disease over a wide geographical areas such as a continent

Rate

the number of events that occur in a given population in a given period of time

Natality

the number of live births

Morbidity

the rate of an illness in a population

Mortality

the number of deaths in a population

Incidence

the number of new cases in a population at risk during a particular period of time; conveys information about the risk of contracting the disease

Prevalence

the number of new and old cases of a disease in a population in a given period of time; tells how widespread the disease is, prevalence=past

Attack

an incidence rate calculated for a particular population for a single disease outbreak

Descriptive studies

describes an epidemic with respect to person, place, and time

Analytical studies

aimed at testing hypotheses

Retrospective studies (case control)

seek to compare thoes diagnosed with a disease with those who do not have the disease for proper exposure to specific risk factors

Prospective studies

a cohort is classified by exposure to one or more specific risk factors and observed into the future to determine the rate at which disease develops

Longitudinal study

a group is observed over a long period of time

Experimental studies

a study carried out under controlled situations, control group, experimental group, may be blind or double blind

Control group

the group that has experimental treatment (intervention) withheld; receives a placebo

Treatment groups

the group that receives the experimental treatment

Blindness

the practice in which the researcher remains uninformed and unaware of the identifiers of treatment and control group members through the period of experiment to prevent bias

Double blind

neither the reseacher nor the subjects know who is receiving the treatment

Characteristics of an Ideal Index

simple, valid, reliable, clear, sensitive, quantifiable, objective, accepted

Reversible index

measures conditionns that can be reversed or resolved

Irreversible index

measures cumulative conditions that cannot be reversed

Simple index

measures the presence or absence of a condition

Cumulative index

measures all the evidence of a condition, past and present

DMFT/DMFS

decayed, missing, filled teeth/surfaces, irreversible, past and present caries experience w/ permanent dentition

deft

decayed, need for extraction, filled teeth, irreversible, observable caries experience in primary teeth

dft/dfs

decayed, filled teeth/surfaces, irreversible, primary teeth

RCI

root caries index, irreversible, must have recession

GI

gingival index, reversible, based on severity of inflammation and location, used to determine prevalence and severity of gingivitis in cohort groups

SBI

sulcular bleeding index, reversible, to detect early signs of gingivitis

PDI

periodontal disease index, ramjford, irreverible, prevalence and severity of periodontal disease, measures both reversible (gingitivits) and irreversible (periodontitis)

PI

periodontal index, irreversible, does not measure attachment loss

PSR

periodontal screening and recording, assesses state of periodontal health rapid and effective, premilinary screening to determine need for full mouth periodontal assessment, uses special probe

CPITN

community periodontal indec of treatment needs, established by WHO to determine periodontal tx needs rather than periodontal status, requires special probe

OHI-S

simplified oral hygiene index, reversible, measures oral hygiene status, involves both debris and calculus index

PLI

plaque index, reversible, measures difference in thickness of soft deposits at gingival margin, used in conjunction with GI

PHP

patient hygiene performance, reversible, assess individual's performance in removing debris after toothbrushing instructions

VMI

volpe-manhold index, reversible, used to test agents for plaque control and calculus inhibition, scores supragingival calculus following prophylaxis

Needs assessment

process by which the program planner identifies and measures gaps between what is and what ought to be, analyze and understand the target population, to collect baseline data for program evaluation

How to conduct a needs assessment?

direct observation, interview, questionnaire, survey, epidemilogical surveys, records, documents, charts

Access to care Need

type of care available

Access to care Demand

type of care desired

Access to care Utilization

actual receipt of dental tx by public

Access to care Barriers

interferences with care to be provided or received

Type I examination

complete examination, includes mouth mirror and explorer, lighting, radiographs, study models, tests as needed

Type II examination

limited examination, includes mouth mirror and explorer, limited radiographs

Type III examination

inspection- mouth mirror and lighting

Type IV examination

screening- tongue depressor, lighting

Goals

broad-based statement of what changes will occur as a result of the program

Objective

specific statement that describes, in a measurable manner, the desired result of the program, based on needs of target population; can be considered steps to achieve the program goals

Formal delivery of teaching

lecture, demonstration, discussion

Informal delivery

brochures, pamphlets, video

Unawareness

the patient has incomplete or inaccurate information

Awareness

correct information is obtained but it still lacks personal meaning

Self-interest

patient personalizes information

Involvement

old ideas are discarded for new ones in an effort to change; motivate to act

Action

the patient tests new concepts; acts based on a perceived need

Habit

the patient begins to experience gratification and self-satisfaction; the behavior is modified