Disney J A, Abernathy J R, Graves R C, Mauriello S M, Bohannan H M, Zack D D
Department of Dental Ecology, University of North Carolina, Chapel Hill 27599-7450.
Community Dent Oral Epidemiol. 1992 Dec;20(6):326-32. doi: 10.1111/j.1600-0528.1992.tb00692.x.
Central to the development of a model for identifying children at high risk to caries is a clinical evaluation to assess dental status and other conditions potentially useful in caries prediction. Traditionally, this evaluation has been based on a relatively lengthy visual/tactile examination conducted by a dentist. Replacing the dentist examination with a dental auxiliary conducted screening evaluation could lead to reduced time and costs. The 4-yr University of North Carolina Caries Risk Assessment Study involved approximately 5000 schoolchildren initially in Grades 1 and 5 living near Aiken, South Carolina, and Portland, Maine. The effectiveness of caries prediction models using visual/tactile examination data were compared with the same models using simplified screening evaluation data. Results showed sensitivity ranged from 0.57 to 0.61 for the visual/tactile and screening models by site and grade cohort. Specificity for the models ranged from 0.80 to 0.83. None of these differences in sensitivity and specificity between visual/tactile (dentist) and screening (hygienist) models was statistically significant. Findings show that for the prediction of children at high risk to dental caries the clinical evaluation may be conducted with no reduction of precision by using dental hygienist performed screening evaluations rather than dentist conducted visual/tactile examinations. While no cost data were collected, these results imply that costs to future prediction programs could be reduced by using screening evaluations.
建立龋齿高危儿童识别模型的核心是进行临床评估，以评估牙齿状况和其他可能对龋齿预测有用的情况。传统上，这种评估是基于牙医进行的相对冗长的视觉/触觉检查。用牙科辅助人员进行的筛查评估取代牙医检查可能会减少时间和成本。为期4年的北卡罗来纳大学龋齿风险评估研究最初涉及约5000名居住在南卡罗来纳州艾肯市和缅因州波特兰市附近的一年级和五年级学童。将使用视觉/触觉检查数据的龋齿预测模型的有效性与使用简化筛查评估数据的相同模型进行了比较。结果显示，按部位和年级队列划分，视觉/触觉模型和筛查模型的敏感性在0.57至0.61之间。这些模型的特异性在0.80至0.83之间。视觉/触觉（牙医）模型和筛查（口腔保健员）模型之间在敏感性和特异性方面的这些差异均无统计学意义。研究结果表明，对于预测龋齿高危儿童，使用口腔保健员进行的筛查评估而非牙医进行的视觉/触觉检查进行临床评估，精度不会降低。虽然未收集成本数据，但这些结果意味着使用筛查评估可能会降低未来预测项目的成本。
