Examination criteria and calibration procedures for prevention trials of the E arly C hildhood C aries C ollaborating C enters
Open accessAbstract
Objectives: To summarize diagnostic criteria and examiner training and calibration of the N ational I nstitute of D ental and C raniofacial R esearch‐funded E arly C hildhood C aries C ollaborating C enters (EC 4) and report examiner calibration results from 2010 to 2014. The EC 4 at B oston U niversity, U niversity of C olorado, and U niversity of C alifornia S an F rancisco are performing randomized controlled early childhood caries (ECC) prevention trials with caries as the main outcome measure. Methods: The EC 4 with U niversity of I owa consultants developed standardized tooth and tooth surface status examination criteria for use in field conditions, examiner training materials, and examiner calibration and re‐calibration methodologies. Calibration and re‐calibration were performed with 1‐ to 5‐year‐old children in the S an F rancisco M ission D istrict in which assessments from each examiner to be calibrated were compared with those from a single gold standard examiner from 2010 to 2014. Cohen's kappa statistic was used to determine inter‐examiner agreement. Results: A total of seven examiners were successfully (re)calibrated during that period, examining a total of 231 children. Overall unweighted C ohen's kappas for 10 surface conditions exceeded the criterion of 0.70. However, separate agreement for assessment of noncavitated lesions, as in other studies, was lower. Conclusions: An experienced multidisciplinary and multi‐institutional team was able to develop criteria and training materials to anticipate situations and field conditions the main trials would encounter. Examiners were successfully trained and (re)calibrated.
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Using ICDAS helps researchers observe subtle intervention effects and nuanced changes from interventions.
“Secondly, the adoption of ICDAS facilitates the observation of subtle intervention effects, allowing researchers to discern nuanced changes resulting from the interventions.6,7”
From Training Protocol and Calibration of the International Caries Detection and Assessment System in a School-Based Clinical Trial of Elementary School-Age Children (2025) · cites this paper as [7]
The Introduction describes ICDAS as a seven-category scale of caries severity, and the Discussion says it can provide a more detailed assessment than the criteria used in these trials. Those passages support its ability to distinguish finer clinical differences, but the paper does not show that ICDAS detects subtle intervention effects or changes resulting from interventions. The indexed passages provide section labels but no page numbers. (LLM, conf=0.84)
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- Authors
- Warren, J. J., Weber‐Gasparoni, K., Tinanoff, N., Batliner, T. S., Jue, B., Santo, W., Garcia, R. I., Gansky, S. A., & Centers, E. C. C. C.
- Affiliations
- University of Iowa (US)
- University of Maryland, Baltimore (US)
- University of Colorado Anschutz (US)
- University of California, San Francisco (US)
- Henry M. Goldman School of Dental Medicine Boston University Boston MA USA
- Corresponding author
- Gansky, Stuart A.
- Venue
- Journal of Public Health Dentistry
- Publisher
- Wiley
- Published
- 2015-05-22
- Volume
- 75
- Issue
- 4
- Pages
- 317-326
- ISSN
- 0022-4006 (ISSN-L)
- 1752-7325
- PMC
- PMC4655186
- OpenAlex
- W1896046750
- Cited by
- 39
- References
- 19
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 4 · 2023: 6 · 2022: 2 · 2021: 4 · 2020: 5 · 2019: 2 · 2018: 7 · 2017: 3 · 2016: 1
- FWCI
- 4.96
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Public Health Dentistry (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Institute of Dental and Craniofacial Research (U54DE019285, U54DE019275, U54DE019259, R21DE08650, U54DE014251)
- 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
- early childhood caries, examiner calibration, inter-examiner agreement, examiner training
- MeSH terms
- Calibration, Child, Dental Caries, Humans, United States
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