title: Diagnostic performance of general dental practitioners after lecture in identifying post-menopausal women with low bone mineral density by panoramic radiographs.
abstract: OBJECTIVE
  Mandibular cortical erosion detected on panoramic radiographs may be useful for identifying post-menopausal women with low skeletal bone mineral density (BMD). The purposes of this study were to calculate the diagnostic performance of general dental practitioners (GDPs) who attended a lecture on identifying post-menopausal women with low BMD from findings on panoramic radiographs and to evaluate the influence of GDPs' age on diagnostic performance.
  
  
  METHODS
  After a 1 h lecture, 111 GDPs were asked to classify the mandibular cortex (normal or eroded) on panoramic radiographs obtained from 100 post-menopausal women who have had skeletal BMD assessment. Low BMD was defined as a BMD T score of -1.0 or less. Diagnostic performance was analysed by comparing two groups classified by mandibular cortex (women with normal cortex and women with any eroded cortex) with those classified by BMD (women with normal BMD and women with low BMD).
  
  
  RESULTS
  The mean sensitivity, specificity, positive predictive value, negative predictive value, accuracy and likelihood ratio for a positive risk result were 73.0% (95% confidence interval [CI]; 71.3 to 74.7%), 49.0% (95% CI; 46.4 to 51.5%), 66.9% (95% CI; 66.0 to 67.8%), 57.0% (95% CI; 55.8 to 58.2%), 62.9% (95% CI; 62.1 to 63.7%) and 1.51 (95% CI; 1.44 to 1.58), respectively. GDPs' age did not influence diagnostic performance.
  
  
  CONCLUSIONS
  Our results suggest that 73.0% of women who had low skeletal BMD can be identified by GDPs after a lecture on the use of panoramic radiographs as an aid in diagnosing low BMD; however, the diagnostic performance may not be influenced by GDPs' age.
authors.affiliation: Department of Oral and Maxillofacial Radiology, Division of Medical Intelligence and Informatics, Hiroshima University, Hiroshima, Japan.
authors.forename: P
authors.initials: P
authors.lastname: Sutthiprapaporn
authors.forename: A
authors.initials: A
authors.lastname: Taguchi
authors.forename: T
authors.initials: T
authors.lastname: Nakamoto
authors.forename: M
authors.initials: M
authors.lastname: Ohtsuka
authors.forename: P C
authors.initials: PC
authors.lastname: Mallick
authors.forename: M
authors.initials: M
authors.lastname: Tsuda
authors.forename: I
authors.initials: I
authors.lastname: Kodama
authors.forename: Y
authors.initials: Y
authors.lastname: Kudo
authors.forename: Y
authors.initials: Y
authors.lastname: Suei
authors.forename: K
authors.initials: K
authors.lastname: Tanimoto
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density; D002983:Clinical Competence; D003945:Diagnosis, Oral / Q000193:education*; D005260:Female; D005792:General Practice, Dental / Q000193:education*; D006801:Humans; D016013:Likelihood Functions; D008336:Mandibular Diseases / Q000000981:diagnostic imaging*; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000000981:diagnostic imaging*; D011862:Radiography, Panoramic; D011871:Radiology / Q000193:education*; D012306:Risk; D012680:Sensitivity and Specificity