Federal University of Pelotas, Graduate Program in Dentistry, Gonçalves Chaves, 457, 5th floor, Pelotas, RS, 96015-560, Brazil.
University Ibirapuera, Graduate Program in Dentistry, Interlagos Avenue, 1329, Sao Paulo, SP, 04661100, Brazil; University of São Paulo, Department of Pediatric Dentistry, School of Dentistry, Lineu Prestes Avenue, 2227, Sao Paulo, SP, 05508000, Brazil.
J Dent. 2018 Aug;75:22-33. doi: 10.1016/j.jdent.2018.05.018. Epub 2018 May 29.
Accuracy studies should associate the diagnostic criteria and outcomes collected to the treatment decision for patients to be considered clinically relevant. This systematic review performed a critical evaluation of the clinical relevance of accuracy studies on the visual and radiographic methods for secondary caries detection, and other aspects.
The search was conducted in PubMed, SCOPUS and ISI Web of knowledge databases.
Accuracy studies assessing clinical and/or radiographic method for evaluation of secondary caries were included. The systematization of the diagnostic criteria, lesion activity assessment and differential diagnosis of secondary caries from factors that can lead to misinterpretations were assessed. Clinical relevance was evaluated by the report of aspects related to: link to treatment decision, evaluation of patient-centered outcomes, establishment of thresholds for non-operative and operative treatment, lesion activity assessment, and reference method. Risk of bias was also assessed. A descriptive analysis was performed.
Following eligibility criteria, 19 articles of the 3089 searched were reviewed. Different diagnostic criteria were reported, mainly for the visual inspection. The use of a standardized diagnostic system, lesion activity assessment and differential diagnosis were described by a limited number of studies. Approximately half of the studies reported association of diagnosis and treatment. Enamel lesions were evaluated radiographically in 28.6% of studies, and visually in 69.2%. Visual diagnosis was more relevant in relation to the operative treatment decision. Patient-centered outcomes were not investigated.
The majority of studies fails to present clinical relevance and report of patient-centered outcomes.
准确性研究应将收集的诊断标准和结果与患者的治疗决策相关联，以使其具有临床相关性。本系统评价对用于检测继发龋的视觉和放射方法的准确性研究的临床相关性进行了批判性评估，以及其他方面。
在 PubMed、SCOPUS 和 ISI Web of Knowledge 数据库中进行了检索。
纳入评估临床和/或放射方法评估继发龋的准确性研究。评估了诊断标准的系统化、病变活动性评估以及继发龋与可能导致误诊的因素的鉴别诊断。临床相关性通过报告与以下方面相关的方面进行评估：与治疗决策的联系、评估以患者为中心的结果、确定非手术和手术治疗的阈值、病变活动性评估以及参考方法。还评估了偏倚风险。进行了描述性分析。
根据纳入标准，对 3089 篇文章中的 19 篇进行了回顾。报告了不同的诊断标准，主要用于目视检查。少数研究描述了使用标准化诊断系统、病变活动性评估和鉴别诊断。大约一半的研究报告了诊断与治疗的关联。有 28.6%的研究对牙釉质病变进行了放射学评估，69.2%的研究进行了目视评估。在手术治疗决策方面，视觉诊断更具相关性。未调查以患者为中心的结果。
大多数研究未能提出临床相关性和以患者为中心的结果报告。
