title: Diagnostic confidence and the accuracy of treatment decisions for radiopaque periapical lesions.
abstract: The periapical radiograph is a tool used in the diagnosis of periapical bone pathology. Radiographic diagnosis might therefore influence endodontic treatment planning and the quality and the cost of dental health care. The hypotheses were tested that (1) the subjective prevalence of a lesion would be associated with the accuracy with which it is diagnosed, (2) 'confident dentists' would be as accurate in their diagnosis as 'doubtful dentists' and (3) the diagnostic confidence of dentists for the diagnosis of periapical pathology would not influence their treatment planning. It was found that the probability of an appropriate treatment decision increased when dentists were relatively confident about a diagnosis. The results showed, furthermore, that the accuracy of diagnostic decisions increased when the dentist's confidence about a particular decision was high. Ways to increase diagnostic accuracy of radiopaque periapical pathology are proposed as a result of this study.
authors.affiliation: Department of Oral Radiology, Academic Centre for Dentistry Amsterdam, The Netherlands.
authors.forename: S E
authors.initials: SE
authors.lastname: Stheeman
authors.forename: P A
authors.initials: PA
authors.lastname: Mileman
authors.forename: M A
authors.initials: MA
authors.lastname: van 't Hof
authors.forename: P F
authors.initials: PF
authors.lastname: van der Stelt
mesh_terms: D002983:Clinical Competence; D003657:Decision Making; D003815:Dentists / Q000523:psychology*; D003937:Diagnosis, Differential; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008336:Mandibular Diseases / Q000000981:diagnostic imaging; D008339:Mandibular Neoplasms / Q000000981:diagnostic imaging; D010000:Osteitis / Q000000981:diagnostic imaging; D012516:Osteosarcoma / Q000000981:diagnostic imaging; D010026:Osteosclerosis / Q000000981:diagnostic imaging; D010347:Patient Care Planning; D010483:Periapical Diseases / Q000000981:diagnostic imaging* / Q000628:therapy; D015995:Prevalence; D011861:Radiography, Dental / Q000592:standards; D012017:Referral and Consultation; D015203:Reproducibility of Results; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires