title: Examiner's experience and the outcome interpretation of ICDAS and Nyvad's system - a prospective in vitro study.
abstract: OBJECTIVE
  To evaluate, prospectively, the influence of examiner's experience in interpreting and applying the caries detection systems ICDAS (IC) and Nyvad (NY).
  
  
  METHODS
  Twelve second-year undergraduate dental students (UG) and 12 postgraduates (PG) MSc level analysed and codified 77 clinical dental caries photographs at three different moments: initially, without any training; after one week of receiving training through a theoretical class; and after two years. Reproducibility and correlation was evaluated; sensitivity, specificity and area under ROC curve (AUC) were dichotomized according to the presence of cavitation (IC) and in relation to disease activity (NY).
  
  
  RESULTS
  IC presented good kappa values for the first two evaluations. Both criteria resulted in good Spearman's correlation after two years (IC = UG: 0.89; PG: 0.93/NY = UG: 0.81; PG: 0.82). Sensitivity, specificity and AUC were statistically higher in the third evaluation by UG for Nyvad.
  
  
  CONCLUSIONS
  ICDAS criteria seem to be instinctively understood by students without clinical experience. Nyvad's concepts performed better after two years where the students deepened their theoretical knowledge and experienced clinical practice, collaborating with the identification of activity signs.
authors.affiliation: a Department of Pediatrics , Araraquara Dental School, UNESP - Univ Estadual Paulista , Araraquara , SP , Brazil.
authors.forename: Vinicius Krieger Costa
authors.initials: VK
authors.lastname: Nogueira
authors.affiliation: a Department of Pediatrics , Araraquara Dental School, UNESP - Univ Estadual Paulista , Araraquara , SP , Brazil.|b Social Dentistry , Araraquara Dental School, UNESP - Univ Estadual Paulista , Araraquara , SP , Brazil.
authors.forename: Diego Girotto
authors.initials: DG
authors.lastname: Bussaneli
authors.affiliation: b Social Dentistry , Araraquara Dental School, UNESP - Univ Estadual Paulista , Araraquara , SP , Brazil.
authors.forename: Elaine Pereira Da Silva
authors.initials: EP
authors.lastname: Tagliaferro
authors.affiliation: c Department of Oral Radiology , Aarhus University , Aarhus C , Denmark.
authors.forename: Rubens
authors.initials: R
authors.lastname: Spin-Neto
authors.affiliation: d Faculty of Dentistry, CES University , Medelin , Colômbia.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Escobar
authors.affiliation: a Department of Pediatrics , Araraquara Dental School, UNESP - Univ Estadual Paulista , Araraquara , SP , Brazil.
authors.forename: Rita De Cássia Loiola
authors.initials: RC
authors.lastname: Cordeiro
mesh_terms: D000328:Adult; D019540:Area Under Curve; D003479:Curriculum; D003731:Dental Caries / Q000145:classification / Q000175:diagnosis*; D003732:Dental Caries Activity Tests / Q000379:methods*; D004497:Education, Dental / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D010808:Physical Examination; D011446:Prospective Studies; D015203:Reproducibility of Results; D013335:Students, Dental; D014094:Tooth, Deciduous / Q000473:pathology; D055815:Young Adult
keywords: Dental caries; diagnosis; education