Risk Assessment for Early Childhood Caries ECC, RAE

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Risk Assessment for Early Childhood Caries (ECC),
RAE

• Support DHHS/NIH/NIDCR,NCMHHD
• U54 DE 14251

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Aims

• Knowledge Discovery Data Mining (KDD) to
  predict Early Childhood Caries (ECC) with
  California Oral Health Needs Assessment (COHNA)
• Test model in Health Kids,
  Healthy Teeth (HKHT)
• Test models in FV RCT (Proj 1)

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What is Knowledge Discovery and Data Mining (KDD)?

• Semi-automatic discovery of patterns,
  associations, anomalies, and statistically
  significant structures in data MIT Tech Review
  (2001)
• Interface of
• Artificial Intelligence Machine Language
• Computer Science Statistics
• Association for Computing Machinery Special
  Interest Group on Knowledge Discovery in Data and
  Data Mining (ACM SIGKDD sponsors KDD Cup)

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KDD Learning Tools

• Supervised
• Regression
• Classification
• k nearest neighbor
• Trees (CART, MART, boosting, bagging)
• Neural Networks
• Generalized Additive Models
• Multivariate Adaptive Regression Splines (MARS)
• Support Vector Machines
• Random Forests

• Unsupervised
• Hierarchical clustering
• K-means

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Modeling Methods
Logistic Regression
Neural Networks
Decision Trees
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Validation

• Split sample (70 training / 30 validation)
• Validation estimates unbiased misclassification
• K-fold Cross Validation
• Mean squared error

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Data Quality
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Critique

• Q N (2000) too small for data mining?
• A 2001 KDD Cup
• N1900 (49 events) 130,000 variables
• Q Whats the practical application?
• A User friendly risk assessment tools
• Q Variable data quality, missingness?
• A

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Results

• ECC health disparities differ by race/ethnicity x
  Head Start status interaction (Shiboski, Gansky
  et al JPHD 2003)
• KDD tools for dental research
• (Gansky Adv Dent Res 2003?)
• 16 / 283 ZIP codes changed 1993 gt 1998

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Modified Plans

• COHNA
• tape unreadable, no raw exam data
• no S-ECC, but other indices
• (deft, dfs, mi-deft, mi-dfs, etc).
• HKHT
• CMS (HCFA) funded 1 year pilot (100K)
• some funds procured, more funding sought
• Arizona Study
• SYHC IOHP Data

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Questions

• Should CANDO Year 3 funds (100K) be used for
  HKHT child dental exams?

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DISCUSSION
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