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普通牙科医生在接受关于全景X线片上钙化颈动脉粥样硬化诊断的短期培训后长期技能的提升。

Long-term skill improvement among general dental practitioners after a short training programme in diagnosing calcified carotid artery atheromas on panoramic radiographs.

作者信息

Gustafsson Nils, Ahlqvist Jan, Levring Jäghagen Eva

机构信息

Oral and Maxillofacial Radiology, Department of Odontology, Umeå University, Umeå, Sweden.

出版信息

Eur J Dent Educ. 2019 Feb;23(1):54-61. doi: 10.1111/eje.12402. Epub 2018 Nov 12.

Abstract

PURPOSE

To study general dental practitioners (GDPs) ability to detect calcified carotid artery atheromas (CCAAs) in panoramic radiographs (PRs) and if their diagnostic accuracy in long term is improved after a short training programme.

METHODS

Fourteen GDPs had their diagnostic accuracy regarding CCAA in PR assessed at baseline, 2 weeks and 1 year after training. Comparison was made with a reference standard based on consensus results from two experienced oral and maxillofacial radiologists. At each session, 100 radiographs were assessed individually by the GDPs. After the baseline assessment, the GDPs participated in a 2-hour training programme comprising a lecture and diagnostic training by calibration. The GDPs results before and after training were compared, as well as between follow-up sessions.

RESULTS

A significant improvement in diagnostic accuracy was observed with increased sensitivity (from 41.8% to 55.7%, P = 0.02) without a significant decrease in specificity (from 87.2% to 86.7%, P = 0.87). The Kappa values also increased (from 0.66 to 0.71, P = 0.04). At 1-year follow-up, the improvement compared to baseline remained significant. There were no significant changes between the 2-week and 1-year follow-up assessment.

CONCLUSION

A short training programme can significantly and sustainable improve GDPs diagnostic accuracy regarding CCAA.

摘要

目的

研究普通牙科医生(GDPs)在全景X线片(PRs)中检测钙化颈动脉粥样斑块(CCAAs)的能力,以及短期培训后其长期诊断准确性是否得到提高。

方法

14名普通牙科医生在基线、培训后2周和1年时接受关于PR中CCAA的诊断准确性评估。与基于两名经验丰富的口腔颌面放射科医生的共识结果的参考标准进行比较。在每次评估中,普通牙科医生分别评估100张X线片。基线评估后,普通牙科医生参加了一个2小时的培训项目,包括一次讲座和校准诊断培训。比较了培训前后普通牙科医生的结果,以及随访期间的结果。

结果

观察到诊断准确性有显著提高,敏感性增加(从41.8%提高到55.7%,P = 0.02),特异性无显著降低(从87.2%降至86.7%,P = 0.87)。Kappa值也增加了(从0.66增加到0.71,P = 0.04)。在1年随访时,与基线相比的改善仍然显著。2周和1年随访评估之间没有显著变化。

结论

短期培训项目可以显著且持续地提高普通牙科医生对CCAA的诊断准确性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7685/7328722/82e3a8e2362b/EJE-23-54-g001.jpg

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