Post-radiation dental index: development and reliability
Post-radiation dental index: development and reliability
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DOI：
10.1007/s00520-007-0393-x
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发表时间：
2008-05-01
影响因子：
3.1
通讯作者：
Wichman, Brian
中科院分区：
文献类型：
--
作者：
Walker, Mary P.;Williams, Karen B.;Wichman, Brian
工作目标本文的目的是开发、验证和评估用于评估放射后牙列破坏的临床指标的可靠性。材料和方法由四名具有放射后患者护理、口腔放射学和矿化组织专业知识的牙医组成的专家小组审查了一系列临床照片（n=60），这些照片描绘了各种各样的放射后病变，这些病变的大小、严重程度和位置。基于与病变严重程度分级和连续破坏沿着分割点相关的面板输入，开发了半定量有序病变量表。一个配套的规模是制定现有的解释。然后，由牙科临床医生/研究人员组成的单独小组对该指数进行审查，以确认其面部和内容效度，并根据他们的输入进行改进。在专家和验证小组批准指数后，两名教育工作者/临床医生评估了该指数的重测可靠性。在简短的校准会议后，检查者审查并独立评分第二系列病变图像（n=60）。一周后，同样的考官独立地对以不同顺序显示的相同图像进行评分。评价者间和评价者内的可靠性和一致性进行了评估（斯皮尔曼r和Kappa统计）。主要结果分别为会话1和2，评价者间的可靠性值为r=0.97和r=0.98，Kappa值为kappa=0.93和kappa=0.95。评价者内信度和一致性分别为0.99和0.98（评价者1），0.98和0.95（评价者2）。结论开发了一种新的指数，并随后证明了表面效度和良好的评价者间和评价者内的信度，潜在的辐射后牙列破坏的严重程度进行评估。
Goals of the work The aim of this paper was to develop, validate, and assess the reliability of a clinical index for assessing post-radiation dentition breakdown.Materials and methods An expert panel of four dentists with expertise in post-radiation patient care, oral radiology, and mineralized tissues reviewed a series of clinical photographs (n=60) depicting a wide range of post-radiation lesions varying in size, severity, and location. Based on panel input related to lesion severity rankings and cut-points along a continuum of destruction, a semiquantitative, ordinal lesion scale was developed. A companion scale was developed to account for existing restorations. The index was then reviewed by a separate panel of dental clinician/researchers for confirmation of face and content validity and was refined based on their input. Following index approval by the expert and confirmatory panels, the index was evaluated for test-retest reliability by two educator/clinicians. After a brief calibration session, examiners reviewed and independently scored a second series of lesion images (n=60). One week later, the same examiners independently scored the same images displayed in a different order. Inter- and intra-rater reliability and agreement were assessed (Spearman r and Kappa statistic).Main results Respective to sessions 1 and 2, inter-rater reliability values were r=0.97 and r=0.98, with Kappa values of kappa=0.93 and kappa=0.95. Respective intra-rater reliability and agreement values were 0.99 and 0.98 (rater 1), and 0.98 and 0.95 (rater 2).Conclusions A new index was developed and subsequently demonstrated face validity and excellent inter- and intra-rater reliability for potentially evaluating the severity of post-radiation dentition breakdown.