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Variables affecting the inter‐ and intra‐examiner reliability of ICDAS for occlusal caries diagnosis in permanent molars
Author(s) -
Qudeimat Muawia A.,
Alomari Qasem D.,
Altarakemah Yacoub,
Alshawaf Nour,
Honkala Eino J.
Publication year - 2015
Publication title -
journal of public health dentistry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.64
H-Index - 63
eISSN - 1752-7325
pISSN - 0022-4006
DOI - 10.1111/jphd.12105
Subject(s) - reproducibility , medicine , molar , kappa , dentistry , cohen's kappa , receiver operating characteristic , orthodontics , permanent teeth , mathematics , statistics , geometry
Objectives The aims of this study were to assess the validity and reproducibility of the I nternational C aries D etection and A ssessment S ystem ( ICDAS ) in detecting occlusal caries in permanent molars and to investigate variables that can affect the reproducibility of ICDAS . Methods Five experienced, trained, and calibrated investigators examined the occlusal surfaces of 142 extracted permanent molars, ranging from sound to cavitated dentine caries. All visual examinations were conducted under standard conditions. Examinations were repeated after a period of 1 and 3 months from the initial examination. After all examinations were completed, teeth were sectioned and histologic validation was undertaken. Maximum kappa statistics were used to assess bias among examiners and linear weighted kappa was used to assess inter‐ and intra‐examiners' reproducibility. Sensitivity, specificity, accuracy and area under the receiver operating characteristic curve were obtained at D 3 threshold. Results Differences in the marginal homogeneity were observed for the general dentist. Kappa for intra‐examiner reproducibility ranged between 0.66 and 0.81 and the inter‐examiner reproducibility ranged between 0.42 and 0.75. ICDAS score of ≥3 presented the best S pearman's correlation coefficient (0.69) at Downer's histologic classification D 3. Corresponding sensitivity and specificity values at that level were 0.73 and 0.95, respectively. While variables like the interval of time between teeth examinations did not affect the intra‐examiner reproducibility, examiners' specialty influenced inter‐examiner's reproducibility over time. Conclusions ICDAS presented acceptable intra‐examiners reproducibility in detecting occlusal caries over time. However, there was a clear effect for examiner's specialty and clinical experience on the inter‐examiner's reproducibility of the ICDAS system at different time intervals.