Development of the Dundee Caries Risk Assessment Model (DCRAM):Risk model development using a novel application of CHAID analysis

Objectives: To use a novel statistical analysis in the development of caries risk assessment models for preschool children for use in a particular community setting. Methods: Data were collected longitudinally on a cohort of approximately 1500 children born in one calendar year in the city of Dundee, Scotland. A dental examination and oral microbiological saliva sample, together with parental and health visitor questionnaires, were completed for each child at ages 1, 2, 3 and 4 years. The 1-year data were analysed using chi-squared automated interaction detector analysis (CHAID) to produce a set of caries risk assessment models for predicting caries in 4-year-olds. Results: Four risk models were developed using CHAID analysis for caries at 4 years of age using risk assessment data collected at age 1. These models included two 'any' caries-risk models (n = 697, dmft >0) and two 'high' caries-risk models (n = 784, dmft =3) depending on the use of the d 1 (enamel and dentine) or d 3 (dentine only) level of caries detection. The most appropriate model developed for use was shown to be the CHAID high caries-risk model at the d 3 level of detection (d 3mft =3). This had a sensitivity of 65% and specificity of 69%. Conclusions: An appropriate risk assessment model for use in a particular community setting predicting caries at age 4 years from data collected at age 1 year was developed. This has been termed the Dundee Caries Risk Assessment Model. © 2011 John Wiley & Sons A/S