Effect of diagnostic threshold on the validity and reliability of epidemiological caries diagnosis using the Dundee Selectable Threshold Method for caries diagnosis (DSTM)
Effect of diagnostic threshold on the validity and reliability of epidemiological caries diagnosis using the Dundee Selectable Threshold Method for caries diagnosis (DSTM)
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DOI：
10.1034/j.1600-0528.2000.280106.x
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发表时间：
2000-02-01
影响因子：
2.3
通讯作者：
Pitts, NB
中科院分区：
文献类型：
--
作者：
Fyffe, HE;Deery, C;Pitts, NB
目的：开发一种在D-1（牙釉质和牙本质）诊断阈值（不丢失D-3信息）记录龋齿的方法，并评估其可靠性、“基准”有效性和对报告的龋齿患病率和需求评估的潜在影响。方法：多名检查员培训、校准和验证试验。两组10名牙科检查员进行了培训，以诊断龋齿在D-1（牙釉质和牙本质）的诊断阈值的条件下的龋齿患病率调查，校准试验之前正在进行。结果如下：在“有经验的检查员”进行了培训，以检查在D-1（牙釉质和牙本质）诊断阈值，在横断面流行病学调查的条件下，有没有显着恶化的检查员之间的协议，对牙齿的评估和一个显着的差异，在两个比较的评估表面上使用的kappa统计。与基准检查者进行评估，与D-3阈值相比，D-1诊断阈值的灵敏度没有显著损失，尽管D-1阈值的特异性显著损失，但所有特异性值都可以被认为是高的。结论：修改通常用于调查龋齿患病率的诊断标准（以允许评估可受益于预防性护理的釉质龋水平以及需要恢复性护理的牙本质龋水平），在青少年中不会对有经验的检查者的可靠性或基准有效性产生显著影响。
Objectives: To develop a method for recording dental caries at the D-1 (enamel and dentine) diagnostic threshold (without loss of D-3 information) and assess its reliability, 'benchmark' validity and potential effects on reported caries prevalence and needs assessment. Methods: Multi-examiner training, calibration and validation trial. Two groups of 10 dental examiners were trained to diagnose dental caries at the D-1 (enamel and dentine) diagnostic threshold under the conditions of a caries prevalence survey, prior to a calibration trial being undertaken. Results: Where 'experienced examiners' were trained to examine at the D-1 (enamel and dentine) diagnostic threshold, under the conditions of a cross-sectional epidemiological survey, there was no significant deterioration in inter-examiner agreement on the assessment of teeth and a significant difference in one of two comparisons on the assessment of surfaces using the kappa statistic. Assessed against a benchmark examiner, there was no significant loss of sensitivity at the D-1 diagnostic threshold compared with the D-3 threshold and, although there was a significant loss of specificity at the D-1 threshold, all specificity values could be considered to be high. Conclusions: Modifying the diagnostic criteria typically used in surveys of caries prevalence (to allow assessment of the levels of enamel caries which could benefit from preventive care as well as dentinal caries requiring restorative care) in adolescents does not adversely affect the reliability or benchmark validity of experienced examiners to a significant degree.