{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T22:48:55Z","timestamp":1793573335663,"version":"4.5.0"},"reference-count":49,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,11,7]],"date-time":"2024-11-07T00:00:00Z","timestamp":1730937600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Clinic Periodontology"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Periodontal disease (PD) screening models based on a self\u2010reported questionnaire were previously established and externally validated. The aim of the present study is to explore whether the screening models could be modified to improve prediction performance; this methodology is called \u2018updating\u2019.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Updating\u00a0the models for \u2018total\u2019 and \u2018severe\u2019 PD was performed using two datasets. One dataset from a previous study (<jats:italic>n<\/jats:italic>\u2009=\u2009155) was used to explore the updating, and a second (<jats:italic>n<\/jats:italic>\u2009=\u2009187, built for the current study) was used to validate whether updating improved performance. Updating was based on different statistical approaches, including model recalibration and revision. Discrimination and calibration were assessed after updating.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>For \u2018total\u2019 PD, the update based on model revision improved its performance. However, still low AUCs were found: 0.64 (0.56\u20130.73) and 0.61 (0.53\u20130.69) with corresponding O:E ratios 1.00 (0.80\u20131.23) and 0.92 (0.75\u20131.13) in the update and validation cohorts, respectively. For \u2018severe\u2019 PD, performance of the original model without update performed still the best; AUCs were 0.72 (0.61\u20130.83) and 0.75 (0.66\u20130.84) in the update and validation cohorts, respectively, with corresponding O:E ratios 0.60 (0.38\u20130.84) and 0.62 (0.42\u20130.87).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The updating methodology did not further improve the performance of the original \u2018severe\u2019 PD screening model; it performed satisfactorily in the medical care setting. Despite updating attempts, the screening model for \u2018total\u2019 PD remained sub\u2010optimal. Screening for \u2018severe\u2019 PD can now be implemented in the medical care setting.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jcpe.14069","type":"journal-article","created":{"date-parts":[[2024,11,8]],"date-time":"2024-11-08T02:24:06Z","timestamp":1731032646000},"page":"387-398","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Attempts to Modify Periodontal Screening Models Based on a Self\u2010Reported Oral Health Questionnaire in the Medical Care Setting"],"prefix":"10.1111","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0723-5537","authenticated-orcid":false,"given":"N.","family":"Nijland","sequence":"first","affiliation":[{"name":"Department of Periodontology, Academic Center for Dentistry Amsterdam (ACTA) University of Amsterdam and Vrije Universiteit Amsterdam  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8034-9410","authenticated-orcid":false,"given":"N.","family":"Su","sequence":"additional","affiliation":[{"name":"Department of Oral Public Health, Academic Center for Dentistry Amsterdam (ACTA) University of Amsterdam and Vrije Universiteit Amsterdam  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V. E. A.","family":"Gerdes","sequence":"additional","affiliation":[{"name":"Department of Vascular Medicine Amsterdam University Medical Center  Amsterdam The\u00a0Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B. 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