Henneberg Sofie, Henriksen Julie, Christensen Lasse, Markvart Merete, Rosing Kasper
Public Employed Dentist Kobenhavn Denmark.
Private and Public Employed Dentist Copenhagen Denmark.
Health Sci Rep. 2024 Sep 5;7(9):e2278. doi: 10.1002/hsr2.2278. eCollection 2024 Sep.
Delayed implementation of new knowledge into clinical practice poses patient safety risks. This study investigates agreement on use of the dental caries interventions, sealing, and stepwise excavation.
A cross-sectional questionnaire survey, based on 11 constructed cases with descriptions of patient symptoms, radiographic, and clinical findings. Interrater agreement on dental caries- and pulp diagnoses and interventions were measured with Cohen's and Light's . The data collection period was September 28 to November 5, 2021. To explore variations in use and knowledge factors, we examined Danish dentists' attitudes toward continuing education.
Based on 243 responses, moderate interrater agreement for dental caries and pulp diagnoses and weak agreement on interventions were seen. The agreement with the gold standard for caries was moderate. No agreement was found for dental pulp diagnosis, and for interventions the agreement was weak. No pattern in agreement with the gold standard was seen in relation to case difficulty level. The majority reported knowing of and using stepwise excavation, in conflict with findings that less than half chose stepwise excavation in cases, where considered appropriate. One in four (25%) reported to be unfamiliar with sealing, and half (50%) use sealing regularly. Better access to continuing education and for universities to offer continuing education as alternatives to one-sided private market were requested.
Some patients may receive too radical treatment despite available less invasive evidence-based effective treatments. Dentists acknowledge the importance of continuing education. Easier access and perhaps more incentives for seeking out high-quality continuing education from trustworthy sources are needed.
新知识在临床实践中的延迟应用会给患者安全带来风险。本研究调查了在使用龋齿干预措施、窝沟封闭和逐步去腐方面的一致性。
基于11个构建病例进行横断面问卷调查，病例包含患者症状、影像学和临床检查结果的描述。采用科恩系数和莱特系数来衡量评估者间在龋齿和牙髓诊断及干预措施上的一致性。数据收集期为2021年9月28日至11月5日。为探究使用情况和知识因素的差异，我们考察了丹麦牙医对继续教育的态度。
基于243份回复，评估者间在龋齿和牙髓诊断上的一致性为中等，在干预措施上的一致性较弱。与龋齿金标准的一致性为中等。在牙髓诊断方面未发现一致性，在干预措施方面一致性较弱。在病例难度水平方面，未发现与金标准一致性的模式。大多数人报告知晓并使用逐步去腐，但这与在认为合适的病例中不到一半的人选择逐步去腐的结果相矛盾。四分之一（25%）的人报告不熟悉窝沟封闭，一半（50%）的人经常使用窝沟封闭。他们要求更好地获得继续教育机会，并且大学能提供继续教育作为单边私人市场的替代选择。
尽管有侵入性较小的循证有效治疗方法，但一些患者可能仍会接受过于激进的治疗。牙医认可继续教育的重要性。需要更便捷地获取继续教育，或许还需要更多激励措施，促使他们从可靠来源寻求高质量的继续教育。
