Dental health and acute myocardial infarction: Author's reply

作者：Kimmo J Mattila · 发表于：BMJ · 年份：1989 · DOI：10.1136/bmj.298.6687.1580 · 被引用次数：2 · 研究领域：Dental Health and Care Utilization、Cardiac Health and Mental Health、Cardiac, Anesthesia and Surgical Outcomes

incidence of myocardial infarction are related to social class.It would have been sensible to match cases and controls for social class as well as for age and sex.Dr Mattila and colleagues went to great lengths to discount social class as a confounding variable, including the use of logistic regression, but they did not include a table to compare the dental indexes for cases and controls within each social class, which would have been very informative.The two methods of assessing dental health are innovative, to say the least, and neither is referenced.The total dental index and the pantomography index included measurements of both caries and periodontal disease.It is more appropriate and more usual to examine for factors associated with caries, a disease predominantly related to diet, with the DMF (delayed, missing, and filled teeth) index,2 and to measure periodontal disease, traditionally related to oral hygiene and age, with the community periodontal index of treatment need (CPITN index).'Whatever index ofdental health is used, it should have been applied by. a single, blinded observer.There are also several misuses of statistics in the paper.Dr Mattila and colleagues claimed that the "high correlation" (r=069) between the pantomography index (which was assessed blind) and the total dental index (which was not) suggests that the total dental index assessment was not biased.The use of correlation is not appropriate in this context,4 nor in assessing the strength of the ass...