Department of Community and Preventive Dentistry, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil.
Department of Health and Nursing Sciences, University of Agder, Kristiansand, Norway.
Community Dent Oral Epidemiol. 2023 Oct;51(5):847-853. doi: 10.1111/cdoe.12775. Epub 2022 Jul 21.
To evaluate the in-lux examination method to assess the reliability of examiners for oral health surveys.
A calibration study involving 10 examiners and 27 patients was conducted, and high-quality photographs of dental epidemiological indices were projected. The latter refers to the in-lux examination method. Two groups, comprised of five examiners each, were trained to assess dental caries (DMFT index) and malocclusion (DAI). The first group carried out in vivo (clinical) and in-lux examinations in the same patients. The second group performed in-lux examinations only. The measurements were repeated to obtain intraexaminer weighted kappa coefficients.
Interexaminer weighted kappa coefficients of the in vivo examination method for DMFT and DAI ranged from 0.597 to 0.851 and from 0.574 to 0.844, respectively. The values for in-lux examination were between 0.440 and 0.856 (DMFT) and between 0.524 and 0.783 (DAI). The intraexaminer kappa coefficients of the in vivo examination method ranged between 0.569 and 0.851 (DMFT) and between 0.644 and 0.834 (DAI). In the in-lux method, these values were between 0.426 and 0.831 (DMFT) and between 0.341 and 0.838 (DAI). Three examiners did not reach the minimum acceptable kappa value (k = 0.610) for DMFT, and one for DAI. Of these, one examiner managed to reach the minimum kappa coefficient for DMFT after additional training. The three others maintained the kappa coefficients at lower than acceptable limits.
Calibration, using both in vivo and in-lux examination methods, was able to discriminate the examiners regarding their reliability to reproduce dental indices. The in-lux examination method was considered reliable and can replace the in vivo examination method. The in-lux method might be more feasible to evaluate the reliability of examiners when clinical calibration is unrealistic due to logistic issues and when a large number of examiners are involved in the survey.
评估口腔健康调查中检查者使用口内片检查方法的可靠性。
本校准研究纳入了 10 名检查者和 27 名患者，对牙体流行病学指数的高质量照片进行了投射。后者指的是口内片检查方法。将五名检查者分为两组，分别接受龋齿（DMFT 指数）和错畸形（DAI）的培训。第一组在同一名患者中进行了体内（临床）和口内片检查。第二组仅进行口内片检查。为了获得检查者内部加权 κ 系数，对测量结果进行了重复。
DMFT 和 DAI 的体内检查方法的检查者间加权 κ 系数范围分别为 0.597 至 0.851 和 0.574 至 0.844。口内片检查的数值在 0.440 至 0.856（DMFT）和 0.524 至 0.783（DAI）之间。体内检查方法的检查者内部 κ 系数范围分别为 0.569 至 0.851（DMFT）和 0.644 至 0.834（DAI）。在口内片方法中，这些值在 0.426 至 0.831（DMFT）和 0.341 至 0.838（DAI）之间。有三名检查者未能达到 DMFT 的最小可接受 κ 值（k=0.610），一名检查者未能达到 DAI 的最小可接受 κ 值。其中，一名检查者在额外培训后达到了 DMFT 的最小 κ 系数。其他三人则将 κ 系数保持在低于可接受的水平。
使用体内和口内片检查方法进行校准，能够区分检查者在再现牙齿指数方面的可靠性。口内片检查方法被认为是可靠的，可以替代体内检查方法。当由于物流问题导致临床校准不切实际且调查涉及大量检查者时，口内片方法可能更适合评估检查者的可靠性。
