Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Feb 9, 2023
Open Peer Review Period: Feb 9, 2023 - Apr 6, 2023
Date Accepted: Aug 30, 2023
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Evaluation of a Digital Decision Support System to Integrate Diabetes and Periodontitis Care: Case-Vignette Study in Online Simulated Environments
ABSTRACT
Background:
As highlighted by the recent WHO Oral Health Resolution, there is an urgent need to better integrate primary and oral health care. Despite evidence and guidelines substantiate the relevance of integrating Type-2 Diabetes Mellitus (T2DM) and periodontitis care, the fragmentation of primary and oral health care persists.
Objective:
This paper reports on the evaluation of a prototypic digital Decision Support System (DSS) which was developed to enhance the integration of T2DM and periodontitis care.
Methods:
The effects of the prototypic DSS were assessed in simulated online environments, using two different sets of case vignettes in combination with evaluation surveys among 202 general dental practitioners (GDPs) and 206 general practitioners (GPs). Each participant evaluated three vignettes, of which one was randomly assisted by the DSS. Logistic regression analyses were conducted on the participant- and case-levels.
Results:
Under DSS assistance, GPs had an 8.3 (95%-CI: 4.32; 16.03) higher odds to recommend a GDP visit. There was no significant impact of DSS-assistance on GP advice about common risk factors for T2DM and periodontal disease. GDPs had a 4.3 (95%-CI: 2.08; 9.04) times higher odds to recommend a GP visit, a 1.6 (95%-CI: 1.03; 2.33) times higher odds to give advice on disease correlations, and a 3.2 (95%-CI: 1.63; 6.35) higher odds to ask patients about their glycated hemoglobin value.
Conclusions:
The findings of this study provide a proof-of-concept for a digital DSS to integrate T2DM and periodontal care. Future updating and testing is warranted to continuously enhance the functionalities of the DSS in terms of interoperability with various types of data-sources and diagnostic devices, incorporation of other (oral) health dimensions, application in various settings including via telemedicine, and further customization of end-user-interfaces.
Citation
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Copyright
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