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检查者的经验以及国际龋病检测与评估系统(ICDAS)和尼瓦德系统的结果解读——一项前瞻性体外研究。

Examiner's experience and the outcome interpretation of ICDAS and Nyvad's system - a prospective in vitro study.

作者信息

Nogueira Vinicius Krieger Costa, Bussaneli Diego Girotto, Tagliaferro Elaine Pereira Da Silva, Spin-Neto Rubens, Escobar Alfonso, Cordeiro Rita De Cássia Loiola

机构信息

a Department of Pediatrics , Araraquara Dental School, UNESP - Univ Estadual Paulista , Araraquara , SP , Brazil.

b Social Dentistry , Araraquara Dental School, UNESP - Univ Estadual Paulista , Araraquara , SP , Brazil.

出版信息

Acta Odontol Scand. 2017 Apr;75(3):186-190. doi: 10.1080/00016357.2016.1277260. Epub 2017 Jan 16.

Abstract

OBJECTIVE

To evaluate, prospectively, the influence of examiner's experience in interpreting and applying the caries detection systems ICDAS (IC) and Nyvad (NY).

MATERIAL AND METHODS

Twelve second-year undergraduate dental students (UG) and 12 postgraduates (PG) MSc level analysed and codified 77 clinical dental caries photographs at three different moments: initially, without any training; after one week of receiving training through a theoretical class; and after two years. Reproducibility and correlation was evaluated; sensitivity, specificity and area under ROC curve (AUC) were dichotomized according to the presence of cavitation (IC) and in relation to disease activity (NY).

RESULTS

IC presented good kappa values for the first two evaluations. Both criteria resulted in good Spearman's correlation after two years (IC = UG: 0.89; PG: 0.93/NY = UG: 0.81; PG: 0.82). Sensitivity, specificity and AUC were statistically higher in the third evaluation by UG for Nyvad.

CONCLUSIONS

ICDAS criteria seem to be instinctively understood by students without clinical experience. Nyvad's concepts performed better after two years where the students deepened their theoretical knowledge and experienced clinical practice, collaborating with the identification of activity signs.

摘要

目的

前瞻性评估检查者的经验对龋病检测系统ICDAS(IC)和尼瓦德(NY)解读及应用的影响。

材料与方法

12名牙科专业本科二年级学生(UG)和12名硕士研究生(PG)在三个不同时间点对77张临床龋齿照片进行分析和编码:最初,未经任何培训;在通过理论课程接受培训一周后;以及两年后。评估了再现性和相关性;根据是否存在龋洞(IC)以及与疾病活动度(NY)的关系,将敏感性、特异性和ROC曲线下面积(AUC)进行二分法分析。

结果

在前两次评估中,IC呈现出良好的kappa值。两年后,两种标准均呈现出良好的斯皮尔曼相关性(IC = UG:0.89;PG:0.93/NY = UG:0.81;PG:0.82)。UG在第三次评估中,尼瓦德的敏感性、特异性和AUC在统计学上更高。

结论

ICDAS标准似乎能被没有临床经验的学生本能地理解。尼瓦德的概念在两年后表现更好,此时学生深化了理论知识并积累了临床实践经验,有助于识别活动体征。

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