EVALUTION OF GUIDELINES FOR PRESCRIBING DENTAL X-RAYS

目前，在美国寻求普通牙科护理的大多数患者都会得到 作为他们最初牙科检查的一部分，他们做了一套完整的口腔X光检查。 最近，设备和放射健康中心(CDRH)发布了一份 报告主张使用一组有限的X射线来治疗这种疾病 初步检查。指导方针的目的是减少患者 在不影响患者护理的情况下通过减少 不必要的X光照片的数量。到目前为止，还没有研究测量 指南的有效性。然而，有证据表明，使用 这样的指导方针会导致漏诊疾病。这项研究的目的是 评估这些指南的临床应用是否减少了 订购的X光照片数量(患者暴露)以及他们的 采用以患者为自身对照的对照组研究设计。 三名牙医将使用指南订购根尖周X线片 大约700名新的成年患者，他们还没有可用的设备 一大堆射线照片。届时将曝光一部完整的口碑系列片。数据关于 患者根尖周X线片中的牙病将收集在 一种配对的、盲目的态度。一组诊断数据将来自 选定的周围片。另一项独立的诊断将从 一套完整的口型。来自两组的疾病信息将是 比较一下。主要的分析路线将包括审查： 减少为成人患者订购的根尖周X线片的数量 首次临床指征出现的时间和遗漏的程度 选定的放射检查的诊断结果和 解释错误的程度。此外，预计 将建议对指南进行修改，以增加其 临床应用。这项研究的结果将提供对 指导方针，如果合适，可能会导致他们的改进和一般 领养。

Currently most patients seeking general dental care in the US receive a complete-mouth set of x-rays as part of their initial dental examination. Recently the Center for Devices and Radiological Health (CDRH) issued a report advocating instead, the use of a limited set of x-rays for this initial examination. the intent of the guidelines is to reduce patient radiation exposure without compromising patient care by decreasing the number of unnecessary radiographs. To date, no studies have measured the efficacy of the guidelines. There is, however, evidence that the use of such guidelines results in missed disease. The aim of this study is to evaluate whether clinical application of these guidelines reduces the number of radiographs ordered (patient exposure) as well as whether their comparison group study design with the patient as his own control is used. Three dentists will use the guidelines to order periapical radiographs for approximately 700 new adult patients who do not already have a usable set of radiographs. A complete-mouth series will then be exposed. Data about the dental disease from patient periapical radiographs will be collected in a paired, blinded manner. One set of diagnosis data will come from the selected periapicals. A separate independent diagnosis will be made from the complete-mouth set. The disease information from the two sets will be compared. The major lines of analysis will include examining: the reduction in number of periapical radiographs ordered for adult patients at time of initial of clinical indications, and the extent of missed diagnostic findings from the selected radiographic examination and the degree of interpretation errors. Further, it is anticipated that modifications in the guidelines will be proposed that will increase their clinical utility. The results of this study will provide validation of the guidelines, which if suitable, may lead to their improvement and general adoption.