Little Budworth, Cheshire CW6 9DA, United Kingdom.
J Dent. 2013 Apr;41(4):328-35. doi: 10.1016/j.jdent.2012.12.009. Epub 2013 Jan 18.
To assess the value of a quality improvement programme for panoramic radiography.
A prospective, cluster randomised controlled trial was conducted in 40 dental practices in England. Practices were randomly assigned into two groups, an 'active' practice receiving regular feedback on film quality and a 'control' practice receiving no feedback until the completion of the study.
800 panoramic radiographs were examined for technical and processing faults. Following the first feedback to the 'active' practices, 100 films showed that the films taken were a significant predictor of a reduction in the number of technical (effect coefficient 0.51 (standard error SE 0.06); P<0.001) and processing (effect coefficient 0.42 (SE 0.08); P<0.001) faults compared to those in 'control' practices (n=400). The 'active' practices continued to benefit from the second round of feedback, showing a marked reduction in technical (effect coefficient 1.31 (SE 0.06); P<0.001) and processing (effect coefficient 1.18 (SE 0.11); P<0.001) faults. Two months after completion of the study, a further 120 panoramic radiographs from 12 practices in each group were examined for quality. Significant differences between the two groups for both technical faults (effect coefficient 0.62 (SE 0.22); P=0.02) and processing faults (effect coefficient 0.65 (SE 0.17); P<0.001) were found.
This cluster randomised controlled trial showed that distance feedback is an effective method in instructing dental practitioners to correct technical and processing errors experienced in producing panoramic radiographs. This intervention was effective in the short term whilst the practitioners were actively receiving feedback and for 8 weeks afterwards.
Panoramic radiography quality is often poor due to a lack of knowledge of correct patient positioning. A failure to comply with manufacturers' instructions regarding the changing frequency for processing chemistry also compounds the problem. Distant feedback is effective in improving film quality in the short term and after 8 weeks.
评估全景放射摄影质量改进计划的价值。
在英格兰的 40 家牙科诊所进行了一项前瞻性、整群随机对照试验。将诊所随机分为两组，一组为“主动”组，定期收到胶片质量反馈，另一组为“对照”组，在研究完成前不提供反馈。
共检查了 800 张全景放射照片，以确定技术和处理故障。在向“主动”实践提供第一次反馈后，100 张胶片表明，所拍摄的胶片是减少技术（效果系数 0.51（标准误差 SE 0.06）；P<0.001）和处理（效果系数 0.42（SE 0.08）；P<0.001）故障的显著预测指标，与“对照”实践（n=400）相比。“主动”实践继续从第二轮反馈中受益，技术（效果系数 1.31（SE 0.06）；P<0.001）和处理（效果系数 1.18（SE 0.11）；P<0.001）故障明显减少。研究完成两个月后，从每组的 12 个实践中又检查了 120 张全景放射照片的质量。两组之间在技术故障（效果系数 0.62（SE 0.22）；P=0.02）和处理故障（效果系数 0.65（SE 0.17）；P<0.001）方面均存在显著差异。
这项整群随机对照试验表明，远程反馈是一种有效的方法，可以指导牙科医生纠正制作全景放射照片时遇到的技术和处理错误。这种干预在短期有效，并且在医生积极接受反馈后持续了 8 周。
由于缺乏正确的患者定位知识，全景放射摄影质量往往很差。不遵守制造商关于更换处理化学物质频率的说明也会加剧这个问题。远程反馈在短期内和 8 周后有效提高胶片质量。
