Is the caries registration reliable? The properties of two indices for visual registration of occlusal caries examined on extracted teeth.

Grein þessi birtist samtímis í Den norske Tannlegeforenings Tidende og Tannlæknablaðinu. Hún var ritrýnd í Norska Tannlæknablaðinu. Efst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinnTilgangur rannsóknarinnar var að bera saman og meta tvo mælikvarða fyrir sjónræna greiningu á bitflatatannskemmdum. Annar mælikvarðinn byggir á texta og myndum en hinn styðst eingöngu við texta. Mælikvarðarnir voru sannreyndir með því að rannsakendur greindu 95 bitfleti í úrdregnum endajöxlum. Síðan var sannreynt með borun í smásjá (referanse standard) hvort tannáta væri til staðar eða ekki. Þar að auki greindu þrír rannsakendur röntgenmyndir af tönnunum. Við samanburð á niðurstöðum út frá Youdens J stuðli virðast mælikvarðarnir því sem næst jafngildir en þó er á þeim munur sem birtist fyrst og fremst við greiningu á byrjandi skemmdum. Töluvert var um vangreiningu á þessum minni skemmdum í rannsókninni. Við greiningu á skemmdum inn í tannbein var hæsta Youdens J gildi fyrir mælikvarða Ekstrands J=0,59. Þar var næmi (sensitivitet) 0,67 og sérhæfi (spesifisitet) 0,78. Samsvarandi fyrir Espelid og Tveit mælikvarðann var J=0,54 með næmi 0,54 og sérhæfi 0,76. Mismunur á milli mælikvarða var ekki marktækur (p>0,05). Ekki tókst að greina allar skemmdir í glerungi sjónrænt. Allar djúpar skemmdir í tannbeini voru greindar á röntgenmyndum en 9 af 27 skemmdum í ysta þriðjungi tannbeins voru vangreindar. Mælt er með samhliða notkun röntgen og sjónrænna greininga. Tannlæknir sem ætlar að bjóða upp á góða meðferð við tannskemmdum, þarf að þekkja eiginleika mælikvarðanna sem hann notast við í greiningu á skemmdum í bitflötum.-----------------------------------------------The study aimed to compare and validate Ekstrand’s index and Espelid and Tveit’s index for registration of occlusal caries. The first index is based on a written description only and the latter uses a combination of manipulated photos with accompanying text. The indices were tested by two observers who recorded occlusal caries on 95 extracted third molars. Gold standard was clinical examination of opened fissures after drilling controlled visually in microscope. Radiographs were examined by three observers. The data were analyzed in crosstables and Youdens J was calculated. The highest Youdens J for visual registration of occlusal caries into dentine was 0.59. Corresponding sensitivity and spesificity values were 0.67 and 0.92 for Ekstrand’s index (cut off point: grade≥3) respectively and for Espelid and Tveit’s index 0.76 and 0.78 (cut off point: grade≥2, Youdens J 0.54). The differences between indices were not statistical significant (p>0.05). Small lesions were on some occasions not recorded visually. The sensitivity and specificity change in inverse directions according to cut off value chosen for the indices. All deeper dentine lesions were identified radiographically, but 9 out of 27 lesions in outer third of dentine were not seen radiographically. A deeper understanding of the properties of diagnostic indices is needed for optimum treatment decisions. Based on the different properties of the clinical and radiographic examinations a combination of methods is recommended

How to do a grounded theory study: a worked example of a study of dental practices

<p>Abstract</p> <p>Background</p> <p>Qualitative methodologies are increasingly popular in medical research. Grounded theory is the methodology most-often cited by authors of qualitative studies in medicine, but it has been suggested that many 'grounded theory' studies are not concordant with the methodology. In this paper we provide a worked example of a grounded theory project. Our aim is to provide a model for practice, to connect medical researchers with a useful methodology, and to increase the quality of 'grounded theory' research published in the medical literature.</p> <p>Methods</p> <p>We documented a worked example of using grounded theory methodology in practice.</p> <p>Results</p> <p>We describe our sampling, data collection, data analysis and interpretation. We explain how these steps were consistent with grounded theory methodology, and show how they related to one another. Grounded theory methodology assisted us to develop a detailed model of the process of adapting preventive protocols into dental practice, and to analyse variation in this process in different dental practices.</p> <p>Conclusions</p> <p>By employing grounded theory methodology rigorously, medical researchers can better design and justify their methods, and produce high-quality findings that will be more useful to patients, professionals and the research community.</p