title: Inter-examiner reliability of salivary diagnostic tests in a practice-based research network.
abstract: OBJECTIVE
  Patient salivary characteristics are being measured as part of the Northwest PRECEDENT (Practice-based REsearch Collaborative in Evidence-based DENTistry) study on caries risk assessment. Prior to the implementation of these salivary diagnostic tests in a practice-based cohort study, inter-examiner reliability was assessed for resting salivary pH, stimulated salivary flow rate, pH and buffering capacity.
  
  
  METHODS
  An initial evaluation of inter-examiner reliability of the 4 salivary tests was conducted among 6 dental auxiliary examiners using a convenience sample of 40 dental students. An in complete block design was used to assign samples to examiners (3 examiners per sample and 20 samples per examiner). Inter-examiner reliability testing was conducted on a patient population representative of the practice-based network in 4 member practices. Two dental assistants per practice independently conducted the salivary tests on samples provided by a random selection of 20 to 25 patients. A separate analysis was performed for each study. For each test, an inter-examiner reliability index was computed.
  
  
  RESULTS
  Results from two studies are reported. In the first, stimulated salivary flow rate demonstrated excellent inter-examiner reliability, and resting salivary pH showed high inter-examiner reliability, while buffering capacity and stimulated salivary pH had moderate and very low inter-examiner reliability, respectively. In the second, inter-examiner reliability was excellent for the stimulated salivary flow rate and the resting salivary pH. The inter-examiner reliability for the stimulated salivary pH was also high and the stimulated salivary buffering capacity test had moderate reliability.
  
  
  CONCLUSIONS
  The small variance in stimulated salivary pH and buffering capacity in dental students may have artificially made the reliability appear low in the first attempt at inter-examiner reliability testing. In the second study, all 4 tests had an accept able performance.
authors.affiliation: Northwest PRECEDENT.
authors.forename: Marilynn
authors.initials: M
authors.lastname: Rothen
authors.forename: Joana
authors.initials: J
authors.lastname: Cunha-Cruz
authors.forename: Lloyd
authors.initials: L
authors.lastname: Mancl
authors.forename: Brian
authors.initials: B
authors.lastname: Leroux
authors.forename: Brooke Latzke
authors.initials: BL
authors.lastname: Davis
authors.forename: Justin
authors.initials: J
authors.lastname: Coyne
authors.forename: Jane
authors.initials: J
authors.lastname: Gillette
authors.forename: Joel
authors.initials: J
authors.lastname: Berg
mesh_terms: D018865:Dental Research / Q000706:statistics & numerical data*; D003945:Diagnosis, Oral / Q000379:methods / Q000706:statistics & numerical data*; D055094:Evidence-Based Dentistry / Q000592:standards*; D006863:Hydrogen-Ion Concentration; D015205:Northwestern United States; D015588:Observer Variation; D015203:Reproducibility of Results; D012463:Saliva / Q000737:chemistry*; D012472:Salivation; D057170:Translational Research, Biomedical