Room for improvement? The accuracy of dental practitioners who diagnose bony pathoses with radiographs.
OBJECTIVE
The impact of any effort aimed at improving diagnostic accuracy by improving clinical decision making in diagnostic radiology will be limited by the ability of the clinician to correctly recognize the presence of abnormalities on radiographs. We carried out a study designed to examine whether dentists are able to correctly identify various kinds of periapical bone lesions visible on intraoral radiographs and diagnose their pathologic nature.


METHODS
General dental practitioners (n = 98) assessed 32 radiographs that showed either normal bone (10) or one abnormality (22) in the periapical bone. The "gold standard" for pathosis was histopathologic analysis. The dentists were asked to judge for the presence of an abnormality and to decide whether an active pathologic process was present.


RESULTS
On average dentists identified 81% of all visible abnormalities correctly. Subsequently, they diagnosed 59% of all the pathologic cases correctly. Dentists, however, incorrectly identified 55% lesions on radiographs when experts had stated that no abnormality was visible.


CONCLUSIONS
There is room for improvement of diagnostic accuracy of bony pathology.
Stheeman
S E
SE
Department of Oral Radiology, Academic Centre for Dentistry Amsterdam, The Netherlands.
Mileman
P A
PA
van' t Hof
M
M
van der Stelt
P F
PF
D000539:Alveolar Process / Q000000981:diagnostic imaging* / Q000473:pathology; D005792:General Practice, Dental / Q000592:standards; D006801:Humans; D007571:Jaw Diseases / Q000000981:diagnostic imaging / Q000473:pathology; D015588:Observer Variation; D010483:Periapical Diseases / Q000000981:diagnostic imaging* / Q000473:pathology; D011859:Radiography; D012680:Sensitivity and Specificity