Effect of diagnostic threshold on the validity and reliability of epidemiological caries diagnosis using the Dundee Selectable Threshold Method for caries diagnosis (DSTM)

Fyffe, Hazel E.; Deery, Chris; Nugent, Zoann J.; Nuttall, Nigel M.; Pitts, Nigel B.

doi:10.1034/j.1600-0528.2000.280106.x

Cited by 128Dental Health and Care UtilizationReliability and Agreement in MeasurementOral microbiology and periodontitis research

Effect of diagnostic threshold on the validity and reliability of epidemiological caries diagnosis using the Dundee Selectable Threshold Method for caries diagnosis (DSTM)

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Fyffe, Hazel E., Deery, Chris, Nugent, Zoann J., Nuttall, Nigel M., Pitts, Nigel B.·2000·Community Dentistry and Oral Epidemiology

DOI 10.1034/j.1600-0528.2000.280106.x

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Abstract

Abstract – Objectives: To develop a method for recording dental caries at the D 1 (enamel and dentine) diagnostic threshold (without loss of D 3 information) and assess its reliability, ‘benchmark’ validity and potential effects on reported caries prevalence and needs assessment. Methods: Multi‐examiner training, calibration and validation trial. Two groups of 10 dental examiners were trained to diagnose dental caries at the D 1 (enamel and dentine) diagnostic threshold under the conditions of a caries prevalence survey, prior to a calibration trial being undertaken. Results: Where ‘experienced examiners’ were trained to examine at the D 1 (enamel and dentine) diagnostic threshold, under the conditions of a cross‐sectional epidemiological survey, there was no significant deterioration in inter‐examiner agreement on the assessment of teeth and a significant difference in one of two comparisons on the assessment of surfaces using the kappa statistic. Assessed against a benchmark examiner, there was no significant loss of sensitivity at the D 1 diagnostic threshold compared with the D 3 threshold and, although there was a significant loss of specificity at the D 1 threshold, all specificity values could be considered to be high. Conclusions: Modifying the diagnostic criteria typically used in surveys of caries prevalence (to allow assessment of the levels of enamel caries which could benefit from preventive care as well as dentinal caries requiring restorative care) in adolescents does not adversely affect the reliability or benchmark validity of experienced examiners to a significant degree.

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Only a small number of trials or epidemiologic studies have reported detailed reliability data for examinations including non-cavitated dental caries.
“Only a small number of trials or epidemiologic studies have reported detailed reliability data for examinations that include non-cavitated dental caries (18–24).”
From Examiner training and reliability in two randomized clinical trials of adult dental caries. (2011) · cites this paper as [20]

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Authors: Fyffe, H. E., Deery, C., Nugent, Z. J., Nuttall, N. M., & Pitts, N. B.
Affiliations: Dundee Dental Hospital (GB)
Corresponding author: Fyffe, Hazel E.
ORCID: Deery, Chris
Pitts, Nigel B.
Venue: Community Dentistry and Oral Epidemiology
Publisher: Wiley
Published: 2000-02
Volume: 28
Issue: 1
Pages: 42-51
ISSN: 0301-5661 (ISSN-L)
1600-0528
DOI: 10.1034/j.1600-0528.2000.280106.x
OpenAlex: W2094808395
Semantic Scholar: c72a643016139384b3a8c6e530c092fe9529e0e6
Cited by: 128
References: 0
Citations by year: 2026: 1 · 2025: 2 · 2024: 1 · 2023: 4 · 2022: 4 · 2021: 5 · 2020: 4 · 2019: 4 · 2018: 5 · 2017: 2 · 2016: 1 · 2015: 8 · 2014: 5 · 2013: 6 · 2012: 9
FWCI: 3.17
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor, 703 d)
Locations: Community Dentistry And Oral Epidemiology (publishedVersion)
PubMed (publishedVersion)
Discovery Research Portal (University of Dundee) (publishedVersion)
Research Portal (King's College London) (submittedVersion)
Funders: University of Dundee
Medical Research Council
Topics: Health Sciences › Dentistry › Periodontics › Dental Health and Care Utilization
Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Reliability and Agreement in Measurement
Health Sciences › Dentistry › Periodontics › Oral microbiology and periodontitis research
Keywords: caries diagnosis, diagnostic thresholds, inter-examiner reliability, diagnostic validity, caries prevalence, enamel caries, dentin caries, adolescents
MeSH terms: Adolescent, Calibration, Dental Caries, DMF Index, Feasibility Studies, Humans, Scotland, Reproducibility of Results, Observer Variation, Prevalence, Benchmarking

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Effect of diagnostic threshold on the validity and reliability of epidemiological caries diagnosis using the Dundee Selectable Threshold Method for caries diagnosis (DSTM)

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