title: Intrarater agreement about the etiology of Class II malocclusion and treatment approach.
abstract: BACKGROUND
  The management of patients with Class II malocclusion has been an ongoing discussion in orthodontics. The aim of this study was to determine whether orthodontists agree among themselves and with each other about the etiology, timing, and difficulty of treating subjects with Class II malocclusion.
  
  
  METHODS
  The initial records of 159 Class II subjects were sent to 8 orthodontists. In this sample, duplicate records of 18 subjects were dispersed. A questionnaire was sent with the records.
  
  
  RESULTS
  The intrarater consistency values were 65% when determining the type of malocclusion, 60% when deciding which arch was at fault, and 81% when determining the need for immediate treatment. Consistency values were 33% regarding case difficulty and 77% regarding phase 2 treatment need. There was a significant negative correlation between the consistency of the orthodontists' responses and the peer assessment rating score.
  
  
  CONCLUSIONS
  We found that practitioners had only moderate agreement among themselves when diagnosing a patient's type of malocclusion and which arch was at fault when a skeletal discrepancy was noted. Intrarater agreement improved as the peer assessment rating score increased, but the correlation was weak, and this was not consistent for all examiners. Because of insufficient intrarater agreement, interrater agreement was not examined.
authors.affiliation: Department of Orthodontics, University of Florida, Gainesville, FL 32610-0444, USA. cdolce@dental.ufl.edu
authors.forename: Calogero
authors.initials: C
authors.lastname: Dolce
authors.forename: David A
authors.initials: DA
authors.lastname: Mansour
authors.forename: Susan P
authors.initials: SP
authors.lastname: McGorray
authors.forename: Timothy T
authors.initials: TT
authors.lastname: Wheeler
mesh_terms: D002648:Child; D005260:Female; D006801:Humans; D008312:Malocclusion, Angle Class II / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy*; D015588:Observer Variation; D009967:Orthodontic Appliances; D009971:Orthodontics, Corrective / Q000295:instrumentation / Q000379:methods*; D018024:Peer Review, Health Care; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires