title: Effect of clinician's experience, age, gender and calibration on the assessment of halitosis.
abstract: OBJECTIVE
  To evaluate the diagnosis of halitosis in relation to the oral malodour judge's experience, age, gender and calibration.
  
  
  METHODS
  This study included 38 dental patients who volunteered to participate. Patients were evaluated for halitosis by 6 clinicians using the organoleptic method and by measuring mouth exhaled air using a halimeter, which is considered the gold standard. Sensitivity, specificity, and positive and negative predictive values were calculated for each clinician. Consistency between clinicians was evaluated through a kappa test. Significance level was set at P < 0.05.
  
  
  RESULTS
  Out of the 38 patients, 14 were diagnosed with halitosis by 6 clinicians using a halimeter. The highest sensitivity (89%) was found for clinician No. 6, followed by clinician No. 5 (78%). Specificities were 57% for clinician No. 4 and 36% for clinician No. 1 and No. 5. The most correct positive predictive value (halitosis according to halimeter readings) was made by clinician No. 6 (65%), who also had the highest rates (83%) of negative predictive value (no halitosis according to halimeter readings). There were no statistically significant differences (P > 0.05) between the diagnoses of clinicians No. 1, 2, 3, 5, or 6; however, the diagnoses made by clinician No. 4 were statistically different (P < 0.05) than those of all other clinicians. The highest rate of agreement (44%) in diagnoses was between the two calibrated clinicians. However, there was no correlation between the halitosis diagnoses and the age, gender and years of experience of the clinicians.
  
  
  CONCLUSIONS
  This study indicates that calibration of clinicians is a significant factor in the organoleptic evaluation of halitosis.
authors.affiliation: Ankara University, Turkey. evirgense@hotmail.com
authors.forename: Sehrazat
authors.initials: S
authors.lastname: Evirgen
authors.forename: Kıvanç
authors.initials: K
authors.lastname: Kamburoğlu
authors.forename: Ayse
authors.initials: A
authors.lastname: Gulsahi
mesh_terms: D000328:Adult; D000367:Age Factors; D001944:Breath Tests; D002983:Clinical Competence; D005260:Female; D006209:Halitosis / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D012680:Sensitivity and Specificity; D012737:Sex Factors