Restorative treatment thresholds and agreement in treatment decision-making
It has been recognised for many years that treatment decision‐making among dentists often shows wide variation. This study sought to examine the effect of dentists’stated treatment thresholds as a source of variation between them, Twenty dentists made 360 treatment decisions about the approximal sur...
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| Veröffentlicht in: | Community dentistry and oral epidemiology 1992-10, Vol.20 (5), p.265-268 |
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| container_title | Community dentistry and oral epidemiology |
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| creator | Kay, Elizabeth Jane Nuttall, Nigel Michael Kniil-Jones, Robin |
| description | It has been recognised for many years that treatment decision‐making among dentists often shows wide variation. This study sought to examine the effect of dentists’stated treatment thresholds as a source of variation between them, Twenty dentists made 360 treatment decisions about the approximal surfaces of extruded teeth seen in simulated bitewing radiographs. They also stated their personal treatment thresholds, i.e. the depth of lesion which they intended to restore. One hundred and ninety pairwise comparisons of treatment decisions showed that only 16% of the dentist pairs showed substantial agreement. Dentist pairs who reported that they held the same interventive threshold achieved exactly the same mean level of agreement in treatment decision‐making as dentist pairs who disagreed about the appropriate threshold for restorative intervention. The study suggests that restorative thresholds which are reported to be used by dentists may be poorly correlated with the number of positive treatment decisions actually made. |
| doi_str_mv | 10.1111/j.1600-0528.1992.tb01696.x |
| format | Article |
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The study suggests that restorative thresholds which are reported to be used by dentists may be poorly correlated with the number of positive treatment decisions actually made.</description><identifier>ISSN: 0301-5661</identifier><identifier>EISSN: 1600-0528</identifier><identifier>DOI: 10.1111/j.1600-0528.1992.tb01696.x</identifier><identifier>PMID: 1424545</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Adolescent ; agreement: decision-making: kappa ; Attitude of Health Personnel ; Chi-Square Distribution ; Clinical Protocols - standards ; Decision Making ; Dental Caries - diagnostic imaging ; Dental Caries - pathology ; Dental Caries - therapy ; Dental Restoration, Permanent - statistics & numerical data ; Dentistry ; Dentists - psychology ; Humans ; Observer Variation ; Patient Care Planning ; Practice Patterns, Physicians' - statistics & numerical data ; Radiography ; treatment thresholds</subject><ispartof>Community dentistry and oral epidemiology, 1992-10, Vol.20 (5), p.265-268</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4085-abc5edc831a85037da0dd35b81d19cd8ee82d1d59a45c9ad723ae96c3397e5703</citedby><cites>FETCH-LOGICAL-c4085-abc5edc831a85037da0dd35b81d19cd8ee82d1d59a45c9ad723ae96c3397e5703</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1600-0528.1992.tb01696.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1600-0528.1992.tb01696.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27903,27904,45553,45554</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/1424545$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kay, Elizabeth Jane</creatorcontrib><creatorcontrib>Nuttall, Nigel Michael</creatorcontrib><creatorcontrib>Kniil-Jones, Robin</creatorcontrib><title>Restorative treatment thresholds and agreement in treatment decision-making</title><title>Community dentistry and oral epidemiology</title><addtitle>Community Dent Oral Epidemiol</addtitle><description>It has been recognised for many years that treatment decision‐making among dentists often shows wide variation. This study sought to examine the effect of dentists’stated treatment thresholds as a source of variation between them, Twenty dentists made 360 treatment decisions about the approximal surfaces of extruded teeth seen in simulated bitewing radiographs. They also stated their personal treatment thresholds, i.e. the depth of lesion which they intended to restore. One hundred and ninety pairwise comparisons of treatment decisions showed that only 16% of the dentist pairs showed substantial agreement. Dentist pairs who reported that they held the same interventive threshold achieved exactly the same mean level of agreement in treatment decision‐making as dentist pairs who disagreed about the appropriate threshold for restorative intervention. The study suggests that restorative thresholds which are reported to be used by dentists may be poorly correlated with the number of positive treatment decisions actually made.</description><subject>Adolescent</subject><subject>agreement: decision-making: kappa</subject><subject>Attitude of Health Personnel</subject><subject>Chi-Square Distribution</subject><subject>Clinical Protocols - standards</subject><subject>Decision Making</subject><subject>Dental Caries - diagnostic imaging</subject><subject>Dental Caries - pathology</subject><subject>Dental Caries - therapy</subject><subject>Dental Restoration, Permanent - statistics & numerical data</subject><subject>Dentistry</subject><subject>Dentists - psychology</subject><subject>Humans</subject><subject>Observer Variation</subject><subject>Patient Care Planning</subject><subject>Practice Patterns, Physicians' - statistics & numerical data</subject><subject>Radiography</subject><subject>treatment thresholds</subject><issn>0301-5661</issn><issn>1600-0528</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1992</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqVkMlOwzAURS0EgjJ8AlLFgl2Ch3gIG4QKhEkgIYal5doPcMkAdgrl72lIBWx5Gy_ufedZB6EdglMyn71JSgTGCeZUpSTPadqOMRG5SGdLaPATLaMBZpgkXAiyhtZjnGBMJBNiFa2SjGY84wN0cQOxbYJp_TsM2wCmraBuh-1zgPjclC4OTe2G5ikAfAe-_tNyYH30TZ1U5sXXT5to5dGUEbYW7wa6Ozm-HZ0ml9fF2ejwMrEZVjwxY8vBWcWIURwz6Qx2jvGxIo7k1ikARR1xPDcZt7lxkjIDubCM5RK4xGwD7fbc19C8Tef_15WPFsrS1NBMo5aMKippV9zvizY0MQZ41K_BVyZ8aoJ1Z1JPdKdLd7p0Z1IvTOrZfHl7cWU6rsD9rvbq5vlBn3_4Ej7_Qdajo-tjKjpC0hN8bGH2QzDhRQvJJNcPV4U-V_cFxsWtLtgXWnyUCA</recordid><startdate>199210</startdate><enddate>199210</enddate><creator>Kay, Elizabeth Jane</creator><creator>Nuttall, Nigel Michael</creator><creator>Kniil-Jones, Robin</creator><general>Blackwell Publishing Ltd</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>199210</creationdate><title>Restorative treatment thresholds and agreement in treatment decision-making</title><author>Kay, Elizabeth Jane ; Nuttall, Nigel Michael ; Kniil-Jones, Robin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4085-abc5edc831a85037da0dd35b81d19cd8ee82d1d59a45c9ad723ae96c3397e5703</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1992</creationdate><topic>Adolescent</topic><topic>agreement: decision-making: kappa</topic><topic>Attitude of Health Personnel</topic><topic>Chi-Square Distribution</topic><topic>Clinical Protocols - standards</topic><topic>Decision Making</topic><topic>Dental Caries - diagnostic imaging</topic><topic>Dental Caries - pathology</topic><topic>Dental Caries - therapy</topic><topic>Dental Restoration, Permanent - statistics & numerical data</topic><topic>Dentistry</topic><topic>Dentists - psychology</topic><topic>Humans</topic><topic>Observer Variation</topic><topic>Patient Care Planning</topic><topic>Practice Patterns, Physicians' - statistics & numerical data</topic><topic>Radiography</topic><topic>treatment thresholds</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kay, Elizabeth Jane</creatorcontrib><creatorcontrib>Nuttall, Nigel Michael</creatorcontrib><creatorcontrib>Kniil-Jones, Robin</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Community dentistry and oral epidemiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kay, Elizabeth Jane</au><au>Nuttall, Nigel Michael</au><au>Kniil-Jones, Robin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Restorative treatment thresholds and agreement in treatment decision-making</atitle><jtitle>Community dentistry and oral epidemiology</jtitle><addtitle>Community Dent Oral Epidemiol</addtitle><date>1992-10</date><risdate>1992</risdate><volume>20</volume><issue>5</issue><spage>265</spage><epage>268</epage><pages>265-268</pages><issn>0301-5661</issn><eissn>1600-0528</eissn><abstract>It has been recognised for many years that treatment decision‐making among dentists often shows wide variation. This study sought to examine the effect of dentists’stated treatment thresholds as a source of variation between them, Twenty dentists made 360 treatment decisions about the approximal surfaces of extruded teeth seen in simulated bitewing radiographs. They also stated their personal treatment thresholds, i.e. the depth of lesion which they intended to restore. One hundred and ninety pairwise comparisons of treatment decisions showed that only 16% of the dentist pairs showed substantial agreement. Dentist pairs who reported that they held the same interventive threshold achieved exactly the same mean level of agreement in treatment decision‐making as dentist pairs who disagreed about the appropriate threshold for restorative intervention. The study suggests that restorative thresholds which are reported to be used by dentists may be poorly correlated with the number of positive treatment decisions actually made.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>1424545</pmid><doi>10.1111/j.1600-0528.1992.tb01696.x</doi><tpages>4</tpages></addata></record> |
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| ispartof | Community dentistry and oral epidemiology, 1992-10, Vol.20 (5), p.265-268 |
| issn | 0301-5661 1600-0528 |
| language | eng |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Adolescent agreement: decision-making: kappa Attitude of Health Personnel Chi-Square Distribution Clinical Protocols - standards Decision Making Dental Caries - diagnostic imaging Dental Caries - pathology Dental Caries - therapy Dental Restoration, Permanent - statistics & numerical data Dentistry Dentists - psychology Humans Observer Variation Patient Care Planning Practice Patterns, Physicians' - statistics & numerical data Radiography treatment thresholds |
| title | Restorative treatment thresholds and agreement in treatment decision-making |
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