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[口腔流行病学中使用的龋失补指数(DMF指数)可重复性的验证及其两种临床形式的评估]

[Validation of the reproducibility of the DMF Index used in bucco-dental epidemiology and evaluation of its 2 clinical forms].

作者信息

Roland E, Gueguen G, Longis M J, Boiselle J

机构信息

Centre de Médecine préventive, Nancy-Vandoeuvre, France.

出版信息

World Health Stat Q. 1994;47(2):44-61.

PMID:8073791
Abstract

The DMF index is the one most commonly used in oral epidemiology to quantify the extent of caries. It represents the total of untreated decayed, missing and filled teeth in a person's mouth. A review of the literature shows that while this index is internationally recognized by the scientific community and people engaged in clinical dental practice, information demonstrating its reproducibility is scanty. The initiation and promotion of studies on the validity of the DMF index depend on first evaluating its reproducibility. This evaluation is based on an analysis of the rate of concordance between the results observed when a sample of subjects is examined twice, either by the same examiner or by two examiners at different times. Three types of comparison were carried out as part of this presentation: comparisons of results by one examiner, between two examiners, and between the two clinical forms of the DMF index according to whether it is calculated by tooth (DMFT) or tooth surface (DMFS). Each of the comparisons covered a group of 50 or so adult subjects selected solely for having an adequate number of teeth presenting different conditions. In all 215 persons were examined twice, making up a total of over 21,000 characters recorded. The state of each of the 32 permanent teeth, or of their 148 surfaces for the DMFS index, was codified using a digit selected from the seven possibilities corresponding to the letters D, M, F, and S (tooth that has not developed, untreated decayed, extracted, filled, healthy, replaced by a fixed or removable prosthesis). The statistical analysis covered 5 variables: the number of decayed, missing, filled and healthy teeth and the DMF index, for the whole mouth and tooth by tooth. The main finding emerging from this study is that for each comparison the rates of concordance are very high, higher for the one-examiner comparisons (> 64%) than for the two-examiner comparisons (> 45%). Comparison between the two types of data-gathering shows rates of over 72% for all the variables. The correlation coefficients between the scores attributed in two successive examinations are all over 0.9, with very small variation intervals even when the rates of concordance are lower. In fact, the differences between the results are generally of the order of +/- 1 tooth. Except in two cases, the Student test (t test) is not significant, which indicates that the means of each of the 5 variables did not differ statistically from one observation to another.(ABSTRACT TRUNCATED AT 400 WORDS)

摘要

龋失补指数(DMF指数)是口腔流行病学中最常用于量化龋齿程度的指标。它代表一个人口腔中未治疗的龋牙、缺失牙和充填牙的总数。文献综述表明,虽然该指数得到了科学界和从事临床牙科实践的人员的国际认可,但证明其可重复性的信息却很少。对DMF指数有效性研究的启动和推广取决于首先评估其可重复性。这种评估基于对同一组受试者由同一检查者或不同时间的两名检查者进行两次检查时所观察到的结果之间的一致性率的分析。作为本报告的一部分,进行了三种类型的比较:同一检查者的结果比较、两名检查者之间的结果比较,以及根据DMF指数是按牙计算(DMFT)还是按牙面计算(DMFS)这两种临床形式之间的比较。每种比较都涵盖了一组约50名成年受试者,这些受试者仅因有足够数量的牙齿呈现不同状况而被挑选出来。总共215人接受了两次检查,记录的字符总数超过21000个。使用从与字母D、M、F和S对应的七种可能性中选择的一个数字对32颗恒牙或DMFS指数中的148个牙面的每一个状态进行编码(未萌出的牙、未治疗的龋牙、拔除的牙、充填的牙、健康的牙、被固定或可摘义齿替代的牙)。统计分析涵盖5个变量:全口和逐个牙齿的龋牙、缺失牙、充填牙和健康牙的数量以及DMF指数。这项研究得出的主要发现是,对于每种比较,一致性率都非常高,同一检查者比较的一致性率(>64%)高于两名检查者比较的一致性率(>45%)。两种数据收集类型之间的比较显示,所有变量的一致性率超过72%。两次连续检查给出的分数之间的相关系数均超过0.9,即使一致性率较低时变化区间也非常小。事实上,结果之间的差异一般在±1颗牙的范围内。除了两个案例外,学生检验(t检验)不显著,这表明5个变量中每个变量的均值在不同观察之间在统计学上没有差异。(摘要截取自400字)

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