Section of Periodontics, Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, Italy.
Division of Periodontology and Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China.
Oral Dis. 2024 Mar;30(2):719-728. doi: 10.1111/odi.14370. Epub 2022 Sep 20.
The purpose of this study was to assess the diagnostic accuracy and the inter-rater agreement among general dentists when staging and grading periodontitis cases with the aid of a software application (SA) developed by the Italian Society of Periodontology and Implantology.
Ten general dentists were asked to independently assess 25 periodontitis cases using the SA. Accuracy was estimated using quadratic weighted kappa and examiners' percentage of agreement with a reference diagnosis provided by a gold standard examiner. Inter-rater agreement was evaluated using Fleiss kappa statistics.
The overall case definition agreed with the reference diagnosis in 53.6% of cases. The agreements for each general dentist's pairwise comparisons against the reference definition were at least substantial in 100% of cases for stage, in 70% of cases for grade and in none of the cases for extent. Fleiss kappa was 0.818, 0.608, and 0.632 for stage, extent, and grade, respectively. The study recognized possible reasons that could lead to decreased accuracy using the SA.
Supported by the SA, general dentists have reached substantial inter-rater agreement and highly accurate assignments of stage and grade. However, complete case definitions were correctly diagnosed in slightly over half of the cases.
本研究旨在评估意大利牙周病学会和种植学会开发的软件应用程序（SA）辅助下，普通牙医在牙周炎病例分期和分级中的诊断准确性和组内一致性。
10 名普通牙医被要求使用 SA 独立评估 25 例牙周炎病例。使用二次加权 Kappa 评估准确性，并根据金标准检查者提供的参考诊断，评估检查者的诊断百分比一致性。使用 Fleiss Kappa 统计评估组内一致性。
在 53.6%的病例中，总体病例定义与参考诊断一致。对于每个普通牙医与参考定义的两两比较，在 100%的病例中，分期的一致性至少为高度一致，在 70%的病例中，分级的一致性为中度一致，而在任何病例中，严重程度的一致性都为无。Fleiss Kappa 分别为 0.818、0.608 和 0.632，用于分期、严重程度和分级。研究确定了使用 SA 可能导致准确性降低的原因。
在 SA 的支持下，普通牙医的分期和分级具有高度的组内一致性和高度准确性。然而，在超过一半的病例中，正确诊断了完整的病例定义。
