Create a response to the following discussion:Describe the diagnostic or screening tool selected, its

Create a response to the following discussion:Describe the diagnostic or screening tool selected, its purpose, and what age group it targets.  
            The Oral Health Assessment Tool (OHAT) was first described by Chalmers et al. in 2005.  The tool is designed to allow non-dental health professionals to screen nursing home residents’ overall oral health.  The tool is intended to be used by health professionals such as nurses during the normal course of caring for a patient, like providing oral care.  Essentially, it is a secondary prevention tool.  The screening tool is broken into eight categories: lips, tongue, gum and tissues, natural teeth, dentures, oral cleanliness, and dental pain (Chalmers et al., 2005).  The tool details what health care professionals should observe as well as indicators of a current or developing problem.  The purpose is to allow health care providers to identify oral health concerns in nursing home patients at the early stage to facilitate professional dental care before more damage is incurred.   In this particular case, the age group is assumed to be the elderly, but would reasonably expand to include any individual who had particular need to be housed in a care facility.   As Chalmers et al. (2005) state, the increased incidence in oral health concerns in that population are largely due to the barriers in place to accessing oral health care, not the age of the residents. 
Has it been specifically tested in this age group?  
            The OHAT was extensively tested by Chalmers et al. in 2005.  The original sample was comprised of 21 residential care facilities in Australia.  Within that sample, 455 residents were participants for the entire length of the study.  There was some attrition of the original residents sample size of 534 due to lack of participation at two facilities.  The mean age of the participants was 82.1 years old (Chalmers et al., 2005, p194). 
Next, discuss the predictive ability of the test. For instance, how do you know the test is reliable and valid? What are the reliability and validity values? What are the predictive values? Is it sensitive to measure what it has been developed to measure, for instance, HIV, or depression in older adults, or Lyme disease? Would you integrate this tool into your advanced practice based on the information you have read about the test, why or why not?
            According to Chalmers et al. (2005), the OHAT is both reliable and valid.  Reliability was reported by percent agreement by category with the lowest being 74.4 for oral cleanliness and the highest being 93.9 for dental pain (Chalmers et al., 2005).  Validity was also shown by category with complete agreement for lips, and high significant correlations and percent agreement for natural teeth, dentures, and tongue (Chalmers et al., 2005). 
According to a systematic review by Everaars et al. (2020), the OHAT continues to be one of the most complete methods of oral health assessment in terms of scope of dental health issues included and one of the most methodologically complete studies as well.  Further investigation by Thapa et al. (2021) in another systematic literature review again reinforced the comprehensiveness of the OHAT as well as the quality of the methodology. 
Since the OHAT is considered by many the gold standard in oral health assessment of elderly residents of nursing homes, it has been implemented all over the world.  In 2020, Klotz et al. detailed the development of a German language version of the tool.  This German language version reported 87% specificity, 86% sensitivity, and 83.1% reliability (Klotz et al., 2020). 
Due to the fact that this particular screening test is truly a comprehensive assessment performed by a healthcare professional, there is no raw data offered that one could use to determine actual predictive ability, or positive and negative predictive values.  I would be interested to see the raw data for both the Chalmers et al. (2005) study as well as the Klotz et al. (2020) study. 
I feel that as an advanced practice nurse, I would definitely use the OHAT as part of my clinical assessment of patients if the opportunity presented itself.  Being aware of the pain and continued health problems that many people suffer as a result of neglected oral health I would absolutely make use of any means necessary to help my patients avoid such issues.  The data reported by both Chalmers et al. (2005) and Klotz et al. (2020) would allow me to feel confident that I would be using a well formulated a reliable tool with the OHAT. 
Reference
Chalmers, J.M., King, P.L., Spencer, A.J., Wright, F.A.C.,