Assaf Andréa Videira, Zanin Luciane, Meneghim Marcelo de Castro, Pereira Antonio Carlos, Ambrosano Gláucia Maria Bovi
Superintendência de Recursos Humanos, Universidade Federal Fluminense, Niterói, Brasil.
Cad Saude Publica. 2006 Sep;22(9):1901-7. doi: 10.1590/s0102-311x2006000900021.
This study compares three measurements (Kappa, general agreement percentage, or GAP, and dice index) used to determine the reproducibility of caries diagnosis in epidemiological surveys under different clinical diagnostic thresholds. Eleven examiners with previous experience in epidemiological surveys were submitted to a theoretical and clinical calibration process. Data analysis used two caries detection thresholds: World Health Organization (WHO) and WHO with the inclusion of initial enamel lesions (WHO + IL). Twenty-three children 6-7 years of age were examined, with and without caries. Mean values for Kappa index, GAP, and Dice were considered high (> 0.90), except for the dice index for the WHO + IL threshold (0.69). Since Kappa is an adjusted agreement index, it can be considered the instrument of choice for calibration of examiners. However, when it is impossible to use, the GAP is recommended together with the dice index in order to orient and improve examiners when examining caries lesions.
本研究比较了三种用于确定不同临床诊断阈值下流行病学调查中龋齿诊断可重复性的测量方法(卡帕值、总体一致性百分比或GAP以及骰子系数)。11名有流行病学调查经验的检查者接受了理论和临床校准过程。数据分析使用了两个龋齿检测阈值:世界卫生组织(WHO)阈值以及纳入初始釉质病变的WHO阈值(WHO + IL)。对23名6至7岁有或无龋齿的儿童进行了检查。除了WHO + IL阈值下的骰子系数(0.69)外,卡帕指数、GAP和骰子系数的平均值被认为较高(> 0.90)。由于卡帕值是一种调整后的一致性指数,它可被视为检查者校准的首选工具。然而,当无法使用卡帕值时,建议同时使用GAP和骰子系数,以便在检查龋齿病变时指导和提高检查者的水平。