Dean's community mottling index, though a useful summary measure, suffers from the use of arbitrary scores and the inability to describe the frequency in each of the levels of mottling. An alternative statistical approach, based on the proportional odds model, is used here to describe the severity of mottling in a community. The use of this model is demonstrated on prevalence data collected on 16 Texas communities.
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Butler et al. (1985) studied this question.