Department of Orthodontics, University of Florida, Gainesville, FL 32610-0444, USA.
Am J Orthod Dentofacial Orthop. 2012 Jan;141(1):17-23. doi: 10.1016/j.ajodo.2011.07.015.
The management of patients with Class II malocclusion has been an ongoing discussion in orthodontics. The aim of this study was to determine whether orthodontists agree among themselves and with each other about the etiology, timing, and difficulty of treating subjects with Class II malocclusion.
The initial records of 159 Class II subjects were sent to 8 orthodontists. In this sample, duplicate records of 18 subjects were dispersed. A questionnaire was sent with the records.
The intrarater consistency values were 65% when determining the type of malocclusion, 60% when deciding which arch was at fault, and 81% when determining the need for immediate treatment. Consistency values were 33% regarding case difficulty and 77% regarding phase 2 treatment need. There was a significant negative correlation between the consistency of the orthodontists' responses and the peer assessment rating score.
We found that practitioners had only moderate agreement among themselves when diagnosing a patient's type of malocclusion and which arch was at fault when a skeletal discrepancy was noted. Intrarater agreement improved as the peer assessment rating score increased, but the correlation was weak, and this was not consistent for all examiners. Because of insufficient intrarater agreement, interrater agreement was not examined.
对于 II 类错颌畸形的患者，其管理一直是正畸学中的一个持续讨论的话题。本研究旨在确定正畸医生之间是否就 II 类错颌畸形的病因、时机和治疗难度达成共识。
将 159 名 II 类错颌患者的初始记录发送给 8 名正畸医生。在这个样本中，分散了 18 名患者的重复记录。随记录一起发送了一份问卷。
当确定错颌类型时，组内一致性值为 65%；当决定哪个牙弓有问题时，组内一致性值为 60%；当确定是否需要立即治疗时，组内一致性值为 81%。关于病例难度的一致性值为 33%，关于第二阶段治疗需求的一致性值为 77%。正畸医生的反应一致性与同行评估评分之间存在显著的负相关。
我们发现，当注意到骨骼差异时，医生在诊断患者的错颌类型和哪个牙弓有问题时，他们之间的一致性仅为中等水平。随着同行评估评分的增加，组内一致性提高，但相关性较弱，而且并非所有检查者都一致。由于组内一致性不足，因此未检查组间一致性。
