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Utilization and Validity of the Dental Diagnostic System over Time in Academic and Private Practice
Open accessAbstract
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.
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“We acknowledge that diagnostic codes, if they were widely recorded in everyday clinical dental practice, would enable a better linkage to health outcomes [24].”
From Structure, function, and productivity from the National Dental Practice-Based Research Network. (2022) · cites this paper as [24]
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Structure, function, and productivity from the National Dental Practice-Based Research Network.
Gilbert, G. H., Fellows, J. L., Allareddy, V., Cochran, D. L., Cunha-Cruz, J., Gordan, V. V., McBurnie, M. A., Meyerowitz, C., Mungia, R., Rindal, D. B., et al. (2022) · Journal of Clinical and Translational Science · doi:10.1017/cts.2022.421 · Cited by 54
“We acknowledge that diagnostic codes, if they were widely recorded in everyday clinical dental practice, would enable a better linkage to health outcomes [24].”
BackgroundKearney, V. P., Yansane, A., Brandon, R. G., Vaderhobli, R. M., Lin, G., Hekmatian, H., Deng, W., Joshi, N., Bhandari, H., Sadat, A. S., et al. (2022) · Journal of Dentistry · doi:10.1016/j.jdent.2022.104211 · Cited by 32
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Current state of dental informatics in the field of health information systems: a scoping review
Ballester, B., Bukiet, F., & Dufour, J.-C. (2022) · BMC Oral Health · doi:10.1186/s12903-022-02163-9 · Cited by 27
Tracking oral health in a standardized, evidence‐based, prevention‐focused dental care system
White, J. M., Brandon, R. G., Mullins, J. M., Simmons, K. L., Kottek, A. M., & Mertz, E. (2020) · Journal of Public Health Dentistry · doi:10.1111/jphd.12413 · Cited by 17
“(13, 31, 32) The clinicians select dental diagnoses before selecting a procedure code using a validated set of standardized diagnostic terminology (13, 33).”
MethodSelf-citation
Metadata
- Authors
- Yansane, A., Tokede, O., White, J., Etolue, J., McClellan, L., Walji, M., Obadan-Udoh, E., & Kalenderian, E.
- Affiliations
- University of California, San Francisco (US)
- Harvard University (US)
- Willamette Dental Group, Portland, OR, USA
- The University of Texas Health Science Center at Houston (US)
- Corresponding author
- Yansane, A.
- Venue
- JDR Clinical & Translational Research
- Publisher
- SAGE Publications
- Published
- 2018-12-08
- Volume
- 4
- Issue
- 2
- Pages
- 143-150
- ISSN
- 2380-0844 (ISSN-L)
- 2380-0852
- PMC
- PMC7068742
- OpenAlex
- W2904027774
- Cited by
- 18
- References
- 19
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 1 · 2023: 1 · 2022: 9 · 2021: 2 · 2020: 1 · 2019: 1
- FWCI
- 1.26
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- JDR Clinical & Translational Research (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Institute of Dental and Craniofacial Research (1R01DE023061-01A1)
- Topics
- Health Sciences › Health Professions › Health Information Management › Medical Coding and Health Information
- Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
- Health Sciences › Nursing › Research and Theory › Nursing Diagnosis and Documentation
- Keywords
- terminology adoption, diagnostic validity, structured documentation, electronic health records, private dental practice, orthodontic treatment, restorative procedures, dental informatics
- MeSH terms
- Dentists, Documentation, Humans, Private Practice, Students, Dental, Electronic Health Records
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