The staging and grading system in defining periodontitis cases: consistency and accuracy amongst periodontal experts, general dentists and undergraduate students
The staging and grading system in defining periodontitis cases: consistency and accuracy amongst periodontal experts, general dentists and undergraduate students
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DOI：
10.1111/jcpe.13406
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发表时间：
2020-12-14
影响因子：
6.7
通讯作者：
Pilloni, Andrea
中科院分区：
文献类型：
--
作者：
Marini, Lorenzo;Tonetti, Maurizio S.;Pilloni, Andrea
目的本研究的目的是评估牙周炎分期和分级系统的一致性和准确性，方法30名参与者（10名牙周专家，10名普通牙科医生和10名本科生）和一个金标准检查员被要求对25例完全记录的牙周炎病例进行两次分类。Fleiss kappa用于评估检查者之间的一致性。使用组内相关系数（ICC）计算不同时间的一致性。结果分期、范围、分级的Fleisskappa值分别为0.48、0.37、0.45;最高的ICC由学生提供的阶段（0.91），而最低的ICC由普通牙医提供的程度（0.79）。与金标准的成对比较显示，分期的平均kappa值>0.81，分级和程度的平均kappa值>0.41。在47.2%的病例中，病例定义的所有三个组成部分均符合金标准。该研究确定了具体的因素与较低的一致性和accuracy.Conclusions诊断是高度一致的跨时间和适度之间的检查。准确性几乎是完美的阶段和中等的等级和程度。需要作出更多的努力来改善对普通牙医的培训。
Aim The objective of this study was to evaluate consistency and accuracy of the periodontitis staging and grading classification system.Methods Thirty participants (10 periodontal experts, 10 general dentists and 10 undergraduate students) and a gold-standard examiner were asked to classify 25 fully documented periodontitis cases twice. Fleiss kappa was used to estimate consistency across examiners. Intraclass correlation coefficient (ICC) was used to calculate consistency across time. Quadratic weighted kappa and percentage of complete agreement versus gold standard were computed to assess accuracy.Results Fleiss kappa for stage, extent and grade were 0.48, 0.37 and 0.45 respectively. The highest ICC was provided by students for stage (0.91), whereas the lowest ICC by general dentists for extent (0.79). Pairwise comparisons against gold standard showed mean value of kappa >0.81 for stage and >0.41 for grade and extent. Agreement with the gold standard for all three components of the case definition was achieved in 47.2% of cases. The study identified specific factors associated with lower consistency and accuracy.Conclusions Diagnosis was highly consistent across time and moderately between examiners. Accuracy was almost perfect for stage and moderate for grade and extent. Additional efforts are required to improve training of general dentists.