de Souza Ana L, Leal Soraya C, Chaves Sacha B, Bronkhorst Ewald M, Frencken Jo E, Creugers Nico H J
Department of Paediatric Dentistry, School of Health Sciences, University of Brasília, Brasília, Brazil; Department of Global Oral Health, College of Dental Sciences, Radboud University Medical Centre, Nijmegen, the Netherlands.
Eur J Oral Sci. 2014 Apr;122(2):149-53. doi: 10.1111/eos.12116. Epub 2014 Feb 17.
The Caries Assessment Spectrum and Treatment (CAST) is a newly developed epidemiological instrument. The aim of this study was to investigate its construct validity. Four calibrated examiners, using CAST codes 0-6, visually examined 109 surfaces of extracted and exfoliated teeth. These teeth were then hemisectioned, photographed, and assessed histologically by two calibrated examiners using the Downer criteria. Twenty-eight of the 109 teeth were scanned using micro-computed tomography (micro-CT) and assessed by the same examiners using the same criteria. Validation was determined through calculation of the sensitivity, specificity, and Youden index for two categories of carious lesions examined visually, with histology and micro-CT as gold standards. Interexaminer consistency was κ = 0.76: SE ± 0.05 between visual and histological assessments of teeth and was κ = 0.89: SE ± 0.08 between visual and micro-CT assessments. For the category 'healthy' vs. 'diseased' (CAST codes 0-2 vs. CAST codes 3-6), sensitivity, specificity, and Youden index values of 100%, 92.9%, and 93%, respectively, for micro-CT, and 96.6%, 86%, and 83%, respectively, for histology, were obtained. For the category 'dentine' vs. 'non-dentine lesions' (CAST codes 0-3 vs. CAST codes 4-6) sensitivity, specificity, and Youden index values of 90%, 100%, and 90%, respectively, for micro-CT, and 81.4%, 100%, and 81%, respectively, for histology, were obtained. Construct validity of the CAST instrument was obtained.
龋病评估光谱与治疗（CAST）是一种新开发的流行病学工具。本研究的目的是调查其结构效度。四名经过校准的检查者使用CAST编码0 - 6，对109颗拔除和脱落牙齿的表面进行了视觉检查。然后将这些牙齿进行半切、拍照，并由两名经过校准的检查者使用唐纳标准进行组织学评估。对109颗牙齿中的28颗进行了微型计算机断层扫描（micro-CT），并由相同的检查者使用相同的标准进行评估。通过计算以组织学和micro-CT作为金标准的视觉检查的两类龋损的敏感性、特异性和尤登指数来确定效度。检查者之间的一致性在牙齿视觉评估与组织学评估之间κ = 0.76：标准误±0.05，在视觉评估与micro-CT评估之间κ = 0.89：标准误±0.08。对于“健康”与“患病”类别（CAST编码0 - 2与CAST编码3 - 6），micro-CT的敏感性、特异性和尤登指数值分别为100%、92.9%和93%，组织学的分别为96.6%、86%和83%。对于“牙本质”与“非牙本质病变”类别（CAST编码0 - 3与CAST编码4 - 6），micro-CT的敏感性、特异性和尤登指数值分别为90%、100%和90%，组织学的分别为81.4%、100%和81%。获得了CAST工具的结构效度。
