Interobserver reliability of methods for paleopathological diagnosis of dental caries.
Interobserver reliability of methods for paleopathological diagnosis of dental caries.
复制标题
龋齿古病理学诊断方法的观察者间可靠性。
DOI：
10.1002/ajpa.1330620303
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发表时间：
1983
影响因子：
2.8
通讯作者：
Brand,JW
中科院分区：
文献类型：
--
作者：
Rudney,JD;Katz,RV;Brand,JW
对于龋病的临床诊断方法是否会在骨骼材料中产生可靠的结果，存在着分歧，而且这些方法的应用程度也存在很大的研究差异。因此，这项研究的目的是评估视觉、触觉和放射学方法在古代人群中评估龋齿评分的观察者间的可靠性。来自Mogollon骨骼样本的33个人被成对的检查员在三个场合进行了评分。第一次考试只用了视觉标准。在第二次检查中，目测法与牙科探测仪相辅相成。在第三次检查中，根据口内X线片对近中和远中表面进行评分。考官独立工作，但在第二次和第三次考试之前，确实根据临床人群的材料进行了校准。考试是在“盲目”的基础上进行的，分析被推迟到所有考试完成之后。龋病分数以每个人存在的总表面积的百分比表示。重复测量方差分析和组内相关系数(ICC)用于估计观察者间的可靠性。视觉评分，ICC值为0.97，不同考生之间差异无统计学意义(P=0.897)。视觉加探索者得分下降至0.9，不同考生之间差异有统计学意义(P=0.003)。对于X线片，IC值为0.86，观察者之间差异无统计学意义(P=0.117)。这些结果表明，临床方法在骨骼人群中不太可靠。可能的错误来源包括龋齿牙本质死后脱水、牙釉质磨损或破裂导致的放射学透光度混乱，以及根面龋病的放射学标准不充分。这些问题可以通过依赖视觉标准来避免。
There is disagreement as to whether clinical methods of caries diagnosis will produce reliable results in skeletal material, and studies vary greatly in the extent to which such methods are employed. The purpose of this study is, therefore, to evaluate the interobserver reliability of visual, tactile, and radiographic methods of scoring dental caries in ancient populations. Thirty‐three individuals from a Mogollon skeletal sample were scored on three occasions by pairs of examiners. The first exam employed visual criteria alone. In the second exam, visual methods were supplemented with the dental explorer. For the third exam, mesial and distal surfaces were scored from “intraoral” radiographs. Examiners worked independently, but did calibrate on material from clinical populations prior to the second and third exams. Exams were conducted on a “blind” basis, and analysis was delayed until all exams were completed. Caries scores were expressed as a percentage of total surfaces present per individual. Repeat‐measures ANOVA and intraclass correlation coefficients (ICC) were used to estimate interobserver reliabilities. For visual scores, ICC = 0.97, and there is no significant difference between examiners (P = 0.897). For visual plus explorer scores, ICC drops to 0.90, and there is a significant difference between examiners (P = 0.003). For the radiographs, ICC = 0.86, and there is no significant difference between observers (P = 0.117). These results suggest that clinical methods are less reliable in skeletal populations. Probable sources of error include postmortem dehydration of carious dentin, confusing radiolucencies engendered by worn or fractured enamel, and inadequate radiologic standards for root caries. These problems can be avoided through reliance on visual criteria.