Restorative treatment decisions from bitewing radiographs--performance of dental epidemiologists and general dental practitioners

Abstract

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.