Hunt R J, Fann S J, Kantor M L, Morris A L
College of Dentistry, University of Iowa, Iowa City.
J Public Health Dent. 1992 Fall;52(5):264-8. doi: 10.1111/j.1752-7325.1992.tb02287.x.
The DEMCAD dental office assessment instrument was developed to evaluate practice quality using Donebedian's quality assessment model of structure, process, and outcome. This previously validated instrument takes about six hours to complete. Subsequent analysis was undertaken to determine whether an abbreviated office assessment based on the evaluation of radiology items was sufficiently sensitive, specific, and practical to be used as a screening instrument for identifying dental offices with very low evaluation scores. Data for this analysis were obtained from 300 volunteer general dental practices evaluated in the field testing of the DEMCAD instrument. The nine radiology structure items predicted very poorly the overall structure scores. However, 13 radiology process items predicted overall process scores quite accurately. Four of the 13 radiology process items (periodontal diagnoses recorded, interdental bone shown on x-rays, caries diagnoses recorded, and current x-rays mounted) produced a combined R2 of .58. These four radiology variables predicted the 10 percent of the dental practices with the lowest overall process score with 87 percent sensitivity and 93 percent specificity. This analysis showed that an abbreviated dental practice process quality assessment using oral radiology items in an audit of patients' records may be feasible as a screening test for dental office assessment.
DEMCAD牙科诊所评估工具是为使用唐贝迪安的结构、过程和结果质量评估模型来评估执业质量而开发的。这个先前经过验证的工具大约需要六个小时才能完成。随后进行了分析，以确定基于放射学项目评估的简化诊所评估对于识别评估分数极低的牙科诊所而言，是否足够敏感、特异且实用，从而可用作筛查工具。该分析的数据来自在DEMCAD工具现场测试中评估的300家志愿普通牙科诊所。九个放射学结构项目对总体结构分数的预测效果很差。然而，13个放射学过程项目对总体过程分数的预测相当准确。13个放射学过程项目中的四个（记录的牙周诊断、X光片显示的牙间骨、记录的龋齿诊断以及已装裱的当前X光片）产生的组合R2为0.58。这四个放射学变量以87%的敏感性和93%的特异性预测了总体过程分数最低的10%的牙科诊所。该分析表明，在对患者记录进行审计时，使用口腔放射学项目进行简化的牙科执业过程质量评估作为牙科诊所评估的筛查测试可能是可行的。
