Benn D K, Dankel D D, Kostewicz S H
University of Florida College of Dentistry 32610-0414, USA.
Proc AMIA Symp. 1998:577-81.
A prototype decision support system has been designed for managing dental caries using a risk assessment model. Caries is a multifactorial disease with risk prediction models having low sensitivity (65%) and moderate specificity (80%) for 2 or more new lesions. These models are inaccurate for targeting resources at high risk people. However, low risk individuals can be more accurately identified. If the activity of early tooth decay lesions, in low risk people, are monitored over time and only lesions beyond 1/3 of the dentin depth are filled, the number of annual fillings may be reduced by 50%. Currently, most US dental schools do not teach risk assessment for caries and encourage early treatment of lesions leading to a repair destruction cycle. The combination of a decision support system with a moderate accuracy specificity risk model for predicting low risk individuals may produce a significant improvement in caries management.
已设计出一个使用风险评估模型来管理龋齿的原型决策支持系统。龋齿是一种多因素疾病，对于预测2个或更多新发损害，风险预测模型的敏感性较低（65%），特异性中等（80%）。这些模型在针对高风险人群分配资源方面并不准确。然而，低风险个体能够被更准确地识别。如果对低风险人群早期龋齿损害的活动进行长期监测，并且仅对牙本质深度超过1/3的损害进行填充，每年的填充数量可能会减少50%。目前，美国大多数牙科学校不教授龋齿风险评估，而是鼓励对损害进行早期治疗，这导致了修复破坏循环。将决策支持系统与用于预测低风险个体的中等准确性特异性风险模型相结合，可能会在龋齿管理方面产生显著改善。
