Training Protocol and Calibration of the International Caries Detection and Assessment System in a School-Based Clinical Trial of Elementary School-Age Children

May combine two claims.

For ICDAS lesion coding, agreement was greater at the >2 cutpoint than at the >1 cutpoint, with Kappa values of 0.72 and 0.77 for the two examiners.

“Kappas for both cutpoints of >2 or >1 for the ICDAS lesion coding indicated greater agreement for >2 cutpoint (Kappa=0.72 and 0.77 for the two examiners, Table 5).”

May combine two claims.

Intra-rater reliability was excellent for lesion and filling scores (0.83 to 0.94) and moderate for activity (0.58) for both trainee dentists.

“The intra-rater reliability indicated excellent reliability for lesion and filling (0.83 to 0.94) and moderate for activity (0.58).”

• Also stated in: § Results · plain

  “The intra-rater reliability for lesion and filling ranged from 0.83 to 0.94, indicating excellent reliability. The intra-rater reliability was moderate for activity at 0.58 for both trainee dentists (Table 4).”

May combine two claims.

Tooth type agreement was 99% between Examiner A and Examiner B and 98% between Examiner A and Examiner C.

“Agreement of tooth type between Examiners A versus B was 99%, and A versus C was 98% (Supplemental Table 2).”

May combine two claims.

Lesion severity weighted Kappa values rose slightly between the first and second examinations, from 0.77 to 0.84 for one trainee and from 0.82 to 0.84 for the other.

“The Kappas increased slightly from the first to second examinations (lesion-weighted Kappa: 0.77 to 0.84 and 0.82 to 0.84).”

May combine two claims.

In the participating children, tooth decay prevalence was 74% when using a lesion score >1 and 61% when using a lesion score >2.

“The prevalence of tooth decay in the cohort of participating children was 74% (using a lesion score >1 for at least one surface/tooth) and 61% (using a lesion score >2 for at least one surface/tooth).”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The ICDAS trainer was a licensed practicing dentist who had performed over 5000 ICDAS examinations and had over a decade of ICDAS training experience.

“The ICDAS trainer is a licensed and practicing dentist, has conducted over 5000 dental examinations using ICDAS, and has conducted trainings for clinical trials and observational research studies using ICDAS for over a decade.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The study protocol and recruitment materials were approved by the Institutional Review Board at the University of Texas Health Science Center at Houston.

“The study protocol and recruitment material were approved by the Institutional Review Board Committee for the Protection of Human Subjects at the University of Texas Health Science Center at Houston.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The dental caries prevalence in the participating children was similar to that reported for Texas children of the same age.

“This prevalence is similar to that seen across Texas for the same age group.4”

• cites [4]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Recording errors could arise because dentists verbally called scores to recorders, and these errors were not measured during training.

“The ICDAS scoring consisted of the dentist verbally calling the score to the recorder, who would then write the scores in the designated field on the case report form. This could lead to recording errors which was not measured during training.”

May combine two claims.

ICDAS training for dentists without prior criteria experience is feasible in a community setting and can produce high reliability and repeatability.

“The study demonstrated that ICDAS training of dentists with no prior criteria experience is feasible in a community setting and can lead to high reliability and repeatability.”

• Also stated in: § Discussion: · hedged

  “Findings were similar to a study by Nelson et al., 2011 reporting high intra-rater reliability for filling, indicating that dental examiners participating in observational longitudinal or clinical trial studies with no experience in ICDAS criteria can be trained and calibrated.10”

Not yet classified.

Missing teeth were not counted as events because a visual examination cannot determine the reason for missingness and missing teeth were expected to exfoliate naturally in this age range.

“Missing tooth was not considered as an event since the reason for a missing tooth cannot be determined with a visual examination only, and missing teeth were expected to naturally exfoliate due to the age range of the children assessed.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Written parental consent and verbal child assent were obtained at the time of measurement.

“Written consent was obtained from the parent and verbal assent was obtained from the child at the time of measurement.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The confidence intervals for Kappa did not adjust for correlation among teeth within the same child.

“No adjustment was made to account for the correlation of the teeth within the same child in the calculation of confidence intervals.”

Classified as probably not a substantial claim. May combine two claims.

The three examiners independently examined each child at least once, and 18 children were examined twice by each examiner.

“Days 3 to 5 of the training consisted of a series of assessments where the three examiners (trainer and trainees) independently examined each child at least once (n=38), of which 18 were assessed twice by each examiner (a total of six assessments for each child to assess whether the agreement improved upon re-assessing the child after calibration).”

Probably not a substantial claim: may not pass S3 (load-bearing).

Because air syringes were not used due to COVID-19 restrictions, identifying certain filling stages, such as partial sealant and tooth-colored fillings, may have been more difficult.

“Restrictions on using air syringes (due to the COVID-19 pandemic) may have caused difficulties in identifying certain stages of tooth fillings, such as partial sealant and tooth-colored fillings.”