Counterpoint: Risk factors, including genetic information, add value in stratifying patients for optimal preventive dental care

The Journal of the American Dental Association
T M BraunW V Giannobile

Abstract

There is disagreement as to whether patient stratification by a combination of diabetes, smoking, and genetic test results is useful for informing the frequency of dental prophylaxes. The authors appeal to basic tenets of clinical study design and statistical analysis of clinical investigations, and highlight how secondary ad hoc analyses, such as those of Diehl and colleagues, are frequently underpowered and inconclusive. They also provide evidence from numerous studies supporting the use of genetics to identify risk. The authors believe the conclusions reached from their original analyses are valid and the analyses of Diehl and colleagues serve to simply reinforce the authors' specific intent of avoiding such underpowered analyses altogether with the Michigan Personalized Prevention Study. Until full genome sequencing in many people with highly specified disease phenotypes is feasible, experimental approaches based on biological findings and hypothesis testing should not be summarily discounted. Stratification of patients to provide "personalized" treatment remains an important, yet elusive, goal. The current debate serves to highlight the need for large, clinical utility studies that can adequately determine how phenotypic a...Continue Reading

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Citations

Dec 31, 2015·European Journal of Oral Sciences·Vibeke Baelum, Rodrigo López
Mar 3, 2015·The Journal of the American Dental Association·John P A Ioannidis
May 1, 2015·The Journal of the American Dental Association·Jeffrey Hyman
Oct 22, 2016·Current Osteoporosis Reports·Alejandro Iglesias-LinaresJames Kennedy Hartsfield

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