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Background <p>This study compared the predictive validity and cost-effectiveness of Cariostat and a reduced Cariogram model for caries risk screening in preschoolers, to guide community-based prevention programs.</p> Methods <p>A longitudinal study was conducted among 156 children (aged 3–4 years) recruited from two randomly selected kindergartens. Baseline assessments included oral examinations, caregiver questionnaires, and caries-risk stratification using Cariostat and the reduced Cariogram. After 12 months, follow-up examinations recorded caries incidence. Predictive performance was analyzed using sensitivity, specificity, and area under the receiver operating characteristic curve (AUC). Cost-effectiveness ratios (CER) and incremental cost-effectiveness ratio (ICER) were calculated per correctly identified moderate-to-high-risk child.</p> Results <p>Among 147 children completing follow-up, 50.3% developed new caries (mean dmft increment: 1.41 ± 0.21). The reduced Cariogram showed higher sensitivity (90.24% vs. 73.17%) but similar specificity (43.08% vs. 44.62%) and AUC (0.71 vs. 0.69) compared to Cariostat. The cost per correctly screened moderate-to-high-risk child was 6-fold lower for the reduced Cariogram (¥14.41 vs. ¥82.68), with a negative ICER of -278.3 favoring the reduced Cariogram.</p> Conclusion <p>The reduced Cariogram outperformed Cariostat in sensitivity and cost-effectiveness for community caries screening, despite modest specificity. Its lower cost and simpler implementation support use in resource-limited settings.</p>

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Predictive validity and cost-effectiveness analysis of two caries risk assessment tools for preschool children

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年8月19日

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  • Cheng Menglin,
  • Chen Yawen,
  • Yu Xingru,
  • Xu Mingyuan,
  • Liao Na,
  • Yang Ying,
  • Huang Xiaofeng

摘要

Background

This study compared the predictive validity and cost-effectiveness of Cariostat and a reduced Cariogram model for caries risk screening in preschoolers, to guide community-based prevention programs.

Methods

A longitudinal study was conducted among 156 children (aged 3–4 years) recruited from two randomly selected kindergartens. Baseline assessments included oral examinations, caregiver questionnaires, and caries-risk stratification using Cariostat and the reduced Cariogram. After 12 months, follow-up examinations recorded caries incidence. Predictive performance was analyzed using sensitivity, specificity, and area under the receiver operating characteristic curve (AUC). Cost-effectiveness ratios (CER) and incremental cost-effectiveness ratio (ICER) were calculated per correctly identified moderate-to-high-risk child.

Results

Among 147 children completing follow-up, 50.3% developed new caries (mean dmft increment: 1.41 ± 0.21). The reduced Cariogram showed higher sensitivity (90.24% vs. 73.17%) but similar specificity (43.08% vs. 44.62%) and AUC (0.71 vs. 0.69) compared to Cariostat. The cost per correctly screened moderate-to-high-risk child was 6-fold lower for the reduced Cariogram (¥14.41 vs. ¥82.68), with a negative ICER of -278.3 favoring the reduced Cariogram.

Conclusion

The reduced Cariogram outperformed Cariostat in sensitivity and cost-effectiveness for community caries screening, despite modest specificity. Its lower cost and simpler implementation support use in resource-limited settings.