Validity assessment and determination of the cutoff value for the Index of Complexity, Outcome and Need among 12-13 year-olds in Southern Chinese.
To validate the use of the Index of Complexity, Outcome and Need (ICON) in assessing orthodontic treatment need among 12-13 year-olds in southern China, we determined the threshold value of ICON based on Chinese orthodontists' judgments. The samples consisted of 335 students in grade 7 from 16 randomly selected middle schools in Chengdu, China. Three associate professors provided ICON scores for each participant and the results were compared with the gold standard judgments from 25 experts on treatment needs. Based on the gold standard, 195 casts belonged to the treatment category, while the rest 140 belonged to the no-treatment category. With the international cutoff point of 43, the sensitivity and specificity of the ICON score were 0.29 and 0.98.The best compromise between sensitivity and specificity in Chengdu, compared with the gold standard, was found at a cutoff point of 29, and the sensitivity and specificity were 0.88 and 0.83. When used to evaluate the treatment need of 12-13 year-olds in southern China, the international ICON cutoff value did not correspond well with Chinese orthodontists' judgments; a lower cutoff value of 29 offered a greater sensitivity and specificity with respect to expert orthodontists' perception of treatment need.
Department of Orthodontics, West China School of Stomatology, Sichuan University, Chengdu, China.
Zheng-Yu
ZY
Liao
Fan
F
Jian
Hu
H
Long
Yun
Y
Lu
Yan
Y
Wang
Zhi
Z
Yang
Yu-Wei
YW
He
Peter
P
Wamalwa
Jing
J
Wang
Nian-Song
NS
Ye
Sheng
S
Wang
Wen-Li
WL
Lai
D000293:Adolescent; D002648:Child; D002681:China / Q000453:epidemiology; D003431:Cross-Cultural Comparison; D003625:Data Collection; D003753:Dental Health Surveys / Q000379:methods / Q000592:standards; D005260:Female; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008310:Malocclusion / Q000175:diagnosis / Q000453:epidemiology*; D020380:Needs Assessment / Q000706:statistics & numerical data*; D015588:Observer Variation; D009971:Orthodontics, Corrective / Q000592:standards* / Q000706:statistics & numerical data; D012016:Reference Values; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity