Downer M C, Kay E J
Eastman Dental Institute for Oral Health Care Sciences, London, England.
Community Dent Oral Epidemiol. 1996 Apr;24(2):101-5. doi: 10.1111/j.1600-0528.1996.tb00823.x.
The object of the study was to compare the performance of a group of eight trained and standardized dental epidemiologists making restorative treatment decisions with that of a group of 20 general dental practitioners. Both groups read the same set of 15 pairs of simulated bitewing radiographs. For each approximal tooth surface image, the examiners were asked to record on a six-point rating scale the confidence with which they would or would not place a restoration. A histological gold standard was available, based on microscopic evaluation of sections of the extracted teeth used for study. The reference criterion was "caries into dentine". The only statistically significant differences in performance between the two groups were at the "definitely" plus "probably" restore rating level. For the proportions of correct decisions out of all treatment decisions at this level, the epidemiologists scored 89% compared with 86% for practitioners (P < 0.01) while for Youden's J index, the corresponding values were 0.44 and 0.34 (P < 0.05). The findings suggest that the benefits in improved performance from examiner training may be small.
该研究的目的是比较一组八名经过培训且标准化的牙科流行病学家与一组二十名普通牙科医生在做出修复治疗决策时的表现。两组人员都阅读了同一组15对模拟咬合翼片X光片。对于每一张邻面牙齿表面图像，检查人员被要求在一个六点量表上记录他们对是否进行修复的信心程度。基于对用于研究的拔除牙齿切片的显微镜评估，有一个组织学金标准。参考标准是“龋坏至牙本质”。两组之间在表现上唯一具有统计学显著差异的是在“肯定”加“可能”进行修复的评级水平。在此水平上，所有治疗决策中正确决策的比例，流行病学家的得分是89%，而从业者为86%（P < 0.01）；对于尤登指数，相应的值分别为0.44和0.34（P < 0.05）。研究结果表明，检查人员培训带来的表现提升益处可能很小。
