A patient-administered medical risk related history questionnaire (EMRRH) for use in 10 European countries (multicenter trial)

Objective. The objective of this study was to produce a standardized medical risk-related history (MRRH) in order to identify the medically compromised patient (MCP) attending the general dental practitioner for treatment, to develop such a history (EMRRH), and to validate it in dental practices in 10 European countries. Study design. The Dutch MRRH, adapted to allow for legal and cultural differences of the participating countries was introduced. After consensus and repeated testing, the questionnaire was validated. In this last phase, 1000 patients older than 18 attending dental practices were selected, 100 per country; 994 medical histories were suitable for statistical analysis. Validation was carried out by a physician accustomed to making preoperative assessments, including the ASA risk classification. Results. Mean specificity per country was 99.1 and per EMRRH item was 99.0. Mean sensitivity per country was 93.2 and per item was 93.7. Cohen's kappa for the countries involved was 0.81 to 0.98 and for subsequent questions was 0.81 to 0.97. Conclusion. The EMRRH was found to be valid in the detection of medically compromised patients in 10 European countries.