Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.
J Prosthodont. 2018 Aug;27(7):636-643. doi: 10.1111/jopr.12558. Epub 2016 Nov 3.
To investigate the effects of evaluator fatigue and level of expertise on the grading of preclinical tooth crown preparations, by global and analytical methods of evaluation.
The study had a double-blind design. Two faculty members, each with more than 10 years of clinical and teaching experience, and two demonstrators with no teaching experience evaluated tooth preparations on maxillary central incisors and mandibular first molars. As a test of the effect of fatigue, preparations were globally (subjective grading) and analytically (criteria-based grading) graded on day 1 (after evaluators had been on duty continuously for 8 hours) and day 2 (in the morning after evaluators had sufficient sleep). Evaluators worked under the same circumstances and did not communicate with each other. The assigned textbooks were used to develop the criteria for grading (rubric) and the predefined exclusion criteria. Grades were recorded and statistically analyzed using statistical software. The paired-sample t-test and Mann-Whitney U test were used for multiple comparisons. Level of significance was set at p ˂ 0.05.
An inconsistency in preclinical tooth preparation evaluation was found to exist by both global and analytical methods. Junior faculty tended to award higher grades than senior faculty did. Furthermore, higher grades were scored by the analytical method. More clinical and academic experience did not guarantee intra- and interexaminer reliability. Younger faculty appeared to tolerate fatigue better than older faculty. Likewise, global evaluation appeared to be more influenced by fatigue than was the analytical method.
There were variations in grading, with no consistently preferred grading method. Evaluator performance after continuous 8-hour duty had no significant effect on preclinical tooth preparation evaluation. Level of expertise did not affect preclinical evaluation regardless of the grading method used.
通过整体和分析评价方法，研究评估者疲劳和专业水平对临床前牙冠预备分级的影响。
本研究采用双盲设计。两名具有 10 年以上临床和教学经验的教师和两名没有教学经验的演示者对上颌中切牙和下颌第一磨牙进行牙预备评估。为了测试疲劳的影响，在第 1 天（评估者连续工作 8 小时后）和第 2 天（评估者有足够睡眠后的上午），对牙预备进行了整体（主观评分）和分析（基于标准评分）评估。评估者在相同的情况下工作，彼此不交流。使用指定的教科书制定分级标准（评分表）和预定义的排除标准。使用统计软件记录和分析等级，并进行统计分析。使用配对样本 t 检验和曼-惠特尼 U 检验进行多重比较。显著性水平设为 p ˂ 0.05。
通过整体和分析方法发现临床前牙预备评估存在不一致性。初级教员比高级教员更倾向于给予更高的分数。此外，分析方法的评分更高。更多的临床和学术经验并不能保证内部和外部检查者的可靠性。年轻的教员似乎比年长的教员更能耐受疲劳。同样，整体评估似乎比分析方法更容易受到疲劳的影响。
存在分级差异，没有一致偏好的分级方法。连续 8 小时值班后评估者的表现对临床前牙预备评估没有显著影响。无论使用何种分级方法，专业水平都不会影响临床前评估。
