比较口腔内摄影龋病评估与既定的视觉龋病评估方法，用于儿童口腔流行病学研究。
Comparison of an intra-oral photographic caries assessment with an established visual caries assessment method for use in dental epidemiological studies of children.
机构信息
The Oral Health Unit, School of Dentistry, University of Manchester, Manchester Academic Health Sciences Centre, Manchester, UK.
出版信息
Community Dent Oral Epidemiol. 2013 Dec;41(6):526-33. doi: 10.1111/cdoe.12049. Epub 2013 Apr 9.
OBJECTIVES
A cross-sectional study was conducted to compare a visual dental examination method developed by the British Association for the Study of Community Dentistry with assessment of intra-oral photographs as means of detecting dental caries in 5-year-olds and 10- to 11-year-olds.
METHOD
130 5-year-olds and 140 10- to 11-year-olds were visually examined by five trained and calibrated examiners. The children also had intra-oral photographs of their teeth taken. The same five examiners assessed the photographs for caries. Both photographic and visual assessments were undertaken at 'caries into dentine' level.
RESULTS
Weighted kappas for the outcome DMFT/dmft as a measure of intra-examiner reliability for the visual examinations ranged from 0.94 to 0.98 (median = 0.98) in the 5-year-olds and 0.80 to 1.00 (median = 0.93) in the 10- to 11-year-olds. Weighted kappas as a measure of intra-examiner reliability for the photographic assessments ranged from 0.83 to 1.00 (median = 0.93) in the 5-year-olds and 0.69 to 0.95 (median = 0.81) in the 10- to 11-year-olds. Sensitivity values for the photographic assessment method as compared to the gold standard of the visual examination scores of a benchmark examiner ranged from 87.8% to 95.8% in the 5-year-olds and 58.5% to 71.7% in the 10- to 11-year-olds.
CONCLUSION
There was good intra-examiner reliability for both the visual and the photographic methods for all the examiners. There are no clinically significant differences between the photographic scores and the visual assessments using any of the metrics described. The photographic approach is therefore equivalent in diagnostic utility to the visual system and confers considerable advantages in terms of examiner bias reduction, remote scoring and archiving. These advantages must be weighed against the modest costs of the cameras and the increase time required to acquire the images.
目的
本横断面研究比较了英国社区牙科研究协会开发的一种可视牙科检查方法与口腔内照片评估，以检测 5 岁和 10-11 岁儿童的龋齿。
方法
对 130 名 5 岁儿童和 140 名 10-11 岁儿童进行了 5 名经过培训和校准的检查者的可视检查。还为这些儿童拍摄了牙齿的口腔内照片。同样的 5 名检查者评估了照片中的龋齿。口腔内照片和可视检查均在“龋齿进入牙本质”水平进行。
结果
5 岁儿童的可视检查结果 DMFT/dmft 作为评估者内可靠性的衡量标准，5 名检查者的加权 Kappa 值范围为 0.94 至 0.98（中位数为 0.98），10-11 岁儿童的加权 Kappa 值范围为 0.80 至 1.00（中位数为 0.93）。5 岁儿童口腔内照片评估者内可靠性的加权 Kappa 值范围为 0.83 至 1.00（中位数为 0.93），10-11 岁儿童的加权 Kappa 值范围为 0.69 至 0.95（中位数为 0.81）。与基准检查者的可视检查评分相比，口腔内照片评估方法的敏感性值在 5 岁儿童中为 87.8%至 95.8%，在 10-11 岁儿童中为 58.5%至 71.7%。
结论
所有检查者的可视和口腔内照片方法都具有良好的评估者内可靠性。使用任何描述的指标，口腔内照片评分与视觉评估之间均无临床显著差异。因此，口腔内照片方法在诊断效用上与视觉系统相当，并在减少评估者偏差、远程评分和存档方面具有很大的优势。这些优势必须与相机的适度成本和获取图像所需的额外时间相权衡。
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