Frencken Jo E, de Souza Ana Luiza, van der Sanden Wil J M, Bronkhorst Ewald M, Leal Soraya Coelho
Department of Global Oral Health, College of Dental Sciences, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
Community Dent Oral Epidemiol. 2013 Feb;41(1):e71-7. doi: 10.1111/cdoe.12027.
To describe the 'Caries Assessment Spectrum and Treatment' (CAST) instrument, its origin and content, and to provide an example of how results can be reported.
The CAST instrument covers the complete range of stages of carious lesion progression: from no carious lesion, through caries protection (sealant) and lesion care (restoration) to lesions in enamel and dentine, the advanced stages of carious lesion progression in pulpal and its consequences on tooth-surrounding tissue and tooth loss due to caries. Using the RAND modified e-Delphi consensus method two independent panels, comprising a total of 56 epidemiologists from 27 countries, determined the face and content validity of CAST. Panellists assessed 17 statements related to the content, description, suitability and international use of CAST. Agreement of 75% or higher was required for reaching consensus on a statement. Construct validity and reliability testing of CAST have been carried out, but results are not yet available.
All 17 statements were approved by the panellists, who found the RAND modified e-Delphi consensus method suitable for achieving consensus. The CAST codes were ordered hierarchically. External validity was obtained. Reporting using CAST can be performed for orally healthy dentitions and those having morbidity and mortality. A DMF score can easily be calculated from the CAST codes, thereby enabling retention of the use of existing DMF scores.
The CAST instrument for use in epidemiological surveys is very promising. Face and content validation is obtained. Construct validity and reliability testing will be completed soon. A structure for reporting results in a comprehensive, pragmatic and easily understood way is being developed.
描述“龋病评估谱与治疗”（CAST）工具、其起源和内容，并提供结果报告示例。
CAST工具涵盖龋病病变进展的各个阶段：从无龋病病变，经过龋病预防（窝沟封闭）和病变护理（修复），到釉质和牙本质病变、龋病病变进展的晚期阶段、牙髓病变及其对牙齿周围组织的影响以及因龋病导致的牙齿缺失。使用兰德改良的电子德尔菲共识方法，由来自27个国家的总共56名流行病学家组成的两个独立小组确定了CAST的表面效度和内容效度。小组成员评估了与CAST的内容、描述、适用性和国际使用相关的17项陈述。就一项陈述达成共识需要75%或更高的一致性。已经对CAST进行了结构效度和信度测试，但结果尚未可得。
所有17项陈述均得到小组成员的认可，他们发现兰德改良的电子德尔菲共识方法适合达成共识。CAST编码按层次顺序排列。获得了外部效度。可以使用CAST对口腔健康的牙列以及有发病和死亡情况的牙列进行报告。可以根据CAST编码轻松计算DMF分数，从而能够保留现有DMF分数的使用。
用于流行病学调查的CAST工具很有前景。获得了表面效度和内容效度。结构效度和信度测试将很快完成。正在开发一种以全面、实用且易于理解的方式报告结果的结构。
