Buchanan K M, Milsom K M, Zoitopoulos L, Pau A, Tickle M
Oral Health Unit, National Primary Care R&D Centre, University of Manchester, Higher Cambridge Street, Manchester, M15 6LP/Halton & St Helens Primary Care Trust.
Br Dent J. 2008 Nov 22;205(10):E19; discussion 560-1. doi: 10.1038/sj.bdj.2008.950. Epub 2008 Oct 31.
To compare the performance of a questionnaire-based assessment of dental pain delivered by non-dental prison nursing staff against a clinical examination performed by an experienced prison dentist (gold standard).
The research fieldwork took place in the healthcare department at HMP Brixton located in South London.
The cohort were those who had complained of dental/facial pain to the prison authorities and were therefore placed on the waiting list for emergency dental care. Subjects were asked to complete the screening test and were then clinically examined by trained and calibrated dentists. The screening test was in the form of a 12-item questionnaire designed to categorise a population reporting dental pain into one of three groups. The screening test results were compared with the diagnosis of a clinical examination.
Ninety-six subjects were recruited during the 16-week study period. Of the 96 prisoners recruited, 27 of those failed to complete the screening test and/or the diagnostic examination even though they had reported pain previously. When sensitivity and specificity values were calculated for the 96 prisoners recruited, the sensitivity was fairly high (81%) and the specificity was poor (33%). However, when these values were calculated for the sub-population, those that completed both the screening test and diagnostic examination (n = 69), the sensitivity did not improve particularly (83%) but the specificity value fell substantially to 13%.
This study highlighted the problems of conducting research in the prison environment, for example increased security preventing researchers from gaining access into the prison and general pressures on prison staff. Additionally, the study demonstrated that screening is not effective in local prisons with a high turnover of prisoners.
比较由非牙科监狱护理人员进行的基于问卷的牙科疼痛评估与经验丰富的监狱牙医进行的临床检查（金标准）的表现。
研究实地调查在位于伦敦南部的布里克斯顿监狱医疗部门进行。
研究对象为那些曾向监狱当局抱怨牙齿/面部疼痛并因此被列入紧急牙科护理等候名单的人。受试者被要求完成筛查测试，然后由经过培训和校准的牙医进行临床检查。筛查测试采用12项问卷的形式，旨在将报告牙齿疼痛的人群分为三组之一。将筛查测试结果与临床检查诊断进行比较。
在为期16周的研究期间招募了96名受试者。在招募的96名囚犯中，有27人尽管之前报告过疼痛，但仍未完成筛查测试和/或诊断检查。当计算96名招募囚犯的敏感性和特异性值时，敏感性相当高（81%），但特异性较差（33%）。然而，当为完成筛查测试和诊断检查的亚组人群（n = 69）计算这些值时，敏感性没有特别提高（83%），但特异性值大幅下降至13%。
本研究突出了在监狱环境中开展研究的问题，例如安保措施加强阻碍研究人员进入监狱以及监狱工作人员面临的一般压力。此外，该研究表明，在囚犯流动率高的地方监狱，筛查并不有效。
