title: Evaluation of a training program for detection of carotid artery calcifications on panoramic radiographs.
abstract: OBJECTIVE
  To evaluate the effectiveness of the American Academy of Oral and Maxillofacial Radiology-sponsored training packet for identification of carotid artery calcifications on panoramic radiographs.
  
  
  METHODS
  Two examiners, who completed the training (trainees), examined 778 panoramic radiographs. The sample included 298 men, with a mean age of 66, and 480 women, with a mean age of 68. Findings were compared with those obtained by an oral and maxillofacial radiologist. A kappa statistic was used to determine agreement between the 2 trainees. The positive predictive value (PPV) of the program was estimated by comparing the trainees rating of disease status with an expert in case identification.
  
  
  RESULTS
  Examiners 1 and 2 identified 99 and 78 positive cases, respectively. A kappa statistic of 0.87 (95% CI, 0.81-0.92) was obtained, indicating good interexaminer agreement. The expert identified 27 positive cases, resulting in a PPV of 34.6% (95% CI, 24.4-46.3).
  
  
  CONCLUSIONS
  Although the training packet offers valuable training, it does not provide a high PPV, suggesting the need to modify it or to seek an expert opinion before classification of a patient as having calcification on a panoramic radiograph.
authors.affiliation: Prosthodontics, University of Rochester Eastman Dental Center, Rochester, NY, USA. dov_almog@urmc.rochester.edu
authors.forename: D M
authors.initials: DM
authors.lastname: Almog
authors.forename: K
authors.initials: K
authors.lastname: Tsimidis
authors.forename: M E
authors.initials: ME
authors.lastname: Moss
authors.forename: R H
authors.initials: RH
authors.lastname: Gottlieb
authors.forename: L C
authors.initials: LC
authors.lastname: Carter
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001161:Arteriosclerosis / Q000000981:diagnostic imaging*; D002114:Calcinosis / Q000000981:diagnostic imaging*; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging*; D002983:Clinical Competence; D003937:Diagnosis, Differential; D003951:Diagnostic Errors / Q000517:prevention & control; D004498:Education, Dental, Continuing; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D015397:Program Evaluation; D011862:Radiography, Panoramic; D011871:Radiology / Q000193:education*