Mobile Health Assessment of Traumatic Dental Injuries Using Smartphone Acquired Photographs: A Multicenter Diagnostic Accuracy Study
2024
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Mobile Health Assessment of Traumatic Dental Injuries Using Smartphone Acquired Photographs: A Multicenter Diagnostic Accuracy Study
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2024
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In review
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Preprint
Abstract
Background: Mobile health (mHealth) has an emerging potential for remote assessment of traumatic dental injuries (TDI) and support of emergency care. This study aimed to determine the diagnostic accuracy of TDI detection from smartphone-acquired photographs.
Methods: The upper and lower anterior teeth of 153 individuals aged ≥ 6 years were photographed using a smartphone camera app. The photos of 148 eligible participants were reviewed independently by a dental specialist, two general dentists, and two dental therapists, using predetermined TDI classification and criteria. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value, and inter-rater reliability were estimated to evaluate the diagnostic performance of the photographic method relative to the reference standard established by the dental specialist.
Results: Of the 1,870 teeth screened, one-third showed TDI; and one-seventh of the participants had primary or mixed dentitions. Compared between the specialist’s reference standard and four dental professionals’ reviews, the diagnostic sensitivity and specificity for TDI versus non-TDI was 59-95% and 47-93%, respectively, with better performance for urgent types of TDI (78-89% and 99-100%, separately). The diagnostic consistency was also better for the primary/mixed dentitions than the permanent dentition.
Conclusion: This study suggested a valid mHealth practice for remote assessment of TDI. A better diagnostic performance in the detection of urgent types of TDI and examination of the primary/mixed dentitions was also reported. Future directions include professional development activities involving dental photography and photographic assessment, incorporation of a machine learning technology to aid photographic reviews, and randomized controlled trials in multiple clinical settings.
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This preprint is under review at the time of submission and may not reflect the final work as published.
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This study was supported with: (i) a Department of Pediatrics Driven to Discover Grant by Minnesota Masonic Charities, (ii) a Regional Development Program Grant by the International Association for Dental Research, (iii) a Global Health Seed Grant by the University of Minnesota Center for Global Health and Social Responsibility, and (iv) a Faculty Start-up Funding for B.H. by the University of Minnesota School of Dentistry.
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Huang, Boyen; Estai, Mohamed; Pungchanchaikul, Patimaporn; Quick, Karin; Ranjitkar, Sarbin; Fashingbauer, Emily; Askar, Abdirahim; Wang, Josiah; Diefalla, Fatma; Shenouda, Margaret; Seyffer, Danae; Louie, Jeffrey P. (2024). Mobile Health Assessment of Traumatic Dental Injuries Using Smartphone Acquired Photographs: A Multicenter Diagnostic Accuracy Study. Retrieved from the University Digital Conservancy, https://hdl.handle.net/11299/261425.
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