title: A multi-centered epidemiological study evaluating the reliability of the treatment difficulty indices developed by the Japan Prosthodontic Society.
abstract: BACKGROUND
  The diagnostic assessment of the level of difficulty in treating patients who need prosthodontic care is useful to establish a medico-economically efficient system with primary care dentists and prosthodontic specialists.
  
  
  METHODS
  A multi-axis assessment protocol was established using the newly established treatment difficulty indices. The protocol contains Axis I: oral physiological conditions (e.g., teeth damage and/or missing teeth); Axis II: general health and sociological conditions (e.g., medical disorders); Axis III: oral health-related quality of life (OHRQOL; e.g., oral health impact profile: OHIP); and Axis IV: psychological health (e.g., mood, anxiety, somatoform disorders). A preliminary study on the test-retest consistency of the protocol was conducted to check the levels of reliability of the indices prior to a large-scale, multi-center cohort study on the validity of the protocol.
  
  
  RESULTS
  The test-retest consistency in terms of the oral physiological condition (Axis I) after data reduction was 0.82 [corrected] for patients with teeth problems, 0.73 [corrected] for partially edentulous patients, and 0.78 [corrected] for edentulous patients. The reliability for general health and sociological conditions (Axis II), OHRQOL (Axis III), and psychological health (Axis IV) were 0.88, 0.74, and 0.61, respectively. These values reflect either "sufficient agreement" or "excellent agreement" in accordance with the criteria established by Landis and Koch (1977) [1].
  
  
  CONCLUSIONS
  This protocol is the first multi-axis assessment scheme introduced for prosthodontic treatment with sufficient reliability. This new system is therefore expected to have a significant impact on future dental diagnostic nomenclature systems.
authors.affiliation: Department of Oral Rehabilitation and Regenerative Medicine, Okayama University Graduate School of Medicine, Dentistry andPharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, Japan.kuboki@md.okayama-u.ac.jp
authors.forename: Takuo
authors.initials: T
authors.lastname: Kuboki
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Ichikawa
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Baba
authors.forename: Masayuki
authors.initials: M
authors.lastname: Hideshima
authors.forename: Yuji
authors.initials: Y
authors.lastname: Sato
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Wake
authors.forename: Kan
authors.initials: K
authors.lastname: Nagao
authors.forename: Yorika
authors.initials: Y
authors.lastname: Kodaira-Ueda
authors.forename: Aya
authors.initials: A
authors.lastname: Kimura-Ono
authors.forename: Katsushi
authors.initials: K
authors.lastname: Tamaki
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Tsuga
authors.forename: Kaoru
authors.initials: K
authors.lastname: Sakurai
authors.forename: Hironobu
authors.initials: H
authors.lastname: Sato
authors.forename: Kanji
authors.initials: K
authors.lastname: Ishibashi
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Yatani
authors.forename: Takashi
authors.initials: T
authors.lastname: Ohyama
authors.forename: Yasumasa
authors.initials: Y
authors.lastname: Akagawa
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Hirai
authors.forename: Keiichi
authors.initials: K
authors.lastname: Sasaki
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Koyano
mesh_terms: D000368:Aged; D002983:Clinical Competence; D002985:Clinical Protocols; D016021:Epidemiologic Studies; D005260:Female; D006304:Health Status; D006801:Humans; D007564:Japan; D007575:Jaw, Edentulous / Q000534:rehabilitation; D008297:Male; D009909:Oral Health; D010361:Patients / Q000523:psychology; D011476:Prosthodontics; D011785:Quality Assurance, Health Care; D015203:Reproducibility of Results; D012923:Social Class; D012953:Societies, Dental; D011795:Surveys and Questionnaires; D016896:Treatment Outcome