A closer look at diagnosis in clinical dental practice: part 3. Effectiveness of radiographic diagnostic procedures.
This article, the third in a series, uses the tools described in the first 2 articles to examine some of the radiographic diagnostic procedures that are employed regularly in dental practice. With a general grounding in the meaning of terms such as sensitivity, specificity, thresholds, kappa coefficients, and predictive values, the reader should now be a more discerning user of the operating characteristic data for dental diagnostic procedures. By re-examining some of these procedures in terms of their effectiveness, accuracy and validity, dental practitioners should be able to use the procedures in a more targeted manner and gain the maximum benefit from their results. With a better understanding of the value of a diagnostic test, the clinician's decision-making process will be far better informed. For example, knowing that a certain radiographic view is associated with a 60% false-positive rate for identifying occlusal caries will preclude blind trust in the results and will help the informed clinician attribute a realistic weight to the radiographic findings. This article considers diagnostic procedures in common use in North American practice, with special emphasis on radiography.
Pretty
Iain A
IA
University of Manchester, Manchester, England. iain.pretty@man.ac.uk
Maupomé
Gerardo
G
D016301:Alveolar Bone Loss / Q000000981:diagnostic imaging; D019540:Area Under Curve; D003661:Decision Support Techniques; D003731:Dental Caries / Q000000981:diagnostic imaging; D003786:Dental Pulp Cavity / Q000000981:diagnostic imaging; D006801:Humans; D010483:Periapical Diseases / Q000000981:diagnostic imaging; D011861:Radiography, Dental; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity