title: Development of quality measurement instruments for root canal treatment.
abstract: OBJECTIVE
  To devise measurement instruments for 'quality' of root canal treatment to assess training and outcome of general dental practitioners working within primary care settings.
  
  
  METHODS
  Scoring systems relating to quality of root canal treatment were developed using expert consensus and published literature. Domains scored included the Treatment Process, Quality of the Obturation, Clinical Healing, Radiographic Healing and Tooth Complexity. Scoring systems were applied to 10 clinical cases treated by each dentist at the beginning and 10 cases treated at the end of their clinical training and 135 cases treated after completion of training. The dentists recorded the treatment process and clinical healing in clinical logs. Two examiners independently scored the radiographs after undertaking calibration and training. Inter- and intra-examiner reliability of scoring radiographic outcomes was tested using Cohen's Kappa statistics.
  
  
  RESULTS
  An instrument was created with four domains to assess quality (two for process and two for outcome of root canal treatment), and a measure of case complexity. Domains of treatment process (n = 240 teeth), outcome (n = 32 teeth) and complexity (n = 215 teeth) were scored using radiographs. The Kappa scores for intra-examiner reliability between 0.22 and 1, whilst inter-examiner reliability ranged between 0.18 and 0.99.
  
  
  CONCLUSIONS
  Evidence-based scores for assessment of the quality (process and outcome) and complexity (structure) of root canal treatment were devised. They were reliable, provided that clinicians were trained in record keeping and examiners have in depth training and calibration in the use of the instruments.
authors.affiliation: Population and Patient Health Division, King's College London Dental Institute, London.|St George's University Hospitals NHS Foundation Trust, London.
authors.forename: S
authors.initials: S
authors.lastname: Eliyas
authors.affiliation: Barts Health NHS Trust, London.
authors.forename: P F A
authors.initials: PFA
authors.lastname: Briggs
authors.affiliation: Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
authors.forename: I R
authors.initials: IR
authors.lastname: Harris
authors.affiliation: Population and Patient Health Division, King's College London Dental Institute, London.
authors.forename: J T
authors.initials: JT
authors.lastname: Newton
authors.affiliation: Population and Patient Health Division, King's College London Dental Institute, London.
authors.forename: J E
authors.initials: JE
authors.lastname: Gallagher
mesh_terms: D002983:Clinical Competence; D004739:England; D055094:Evidence-Based Dentistry / Q000379:methods*; D005792:General Practice, Dental / Q000592:standards*; D006801:Humans; D010043:Outcome and Process Assessment, Health Care / Q000379:methods*; D011785:Quality Assurance, Health Care; D012390:Root Canal Therapy / Q000592:standards*
keywords: outcome of root canal treatment; quality measures for root canal treatment; quality of root canal treatment