Archived posting to the Leica Users Group, 2015/03/05
[Author Prev] [Author Next] [Thread Prev] [Thread Next] [Author Index] [Topic Index] [Home] [Search]Larry -- I see your point but I think your recommendation is too bold. I did the examiner training for the two earlier NHANES surveys and also the NIDR studies of dental caries of school children conducted in the 1980s. In the latter, as an example, the F component accounted for around 80% of caries diagnoses by the examiners. Granted, this number included many (unknown) instances of unnecessary fillings, but completely ignoring it would skew the prevalence estimates to the point of being essentially meaningless. It would also skew the data by demographics, since populations with good access to care would likely have more F surfaces than those who lacked access. There are also problems with the D and M components. One young examiner I trained found 14 D surfaces in a subject in whom the reference examiner (me) found only 2, and many M teeth are missing for reasons other than caries. These issues have been discussed at length by those of us who did the field exams and/or calibrated the examiners. There's no question that the F component is a source of some false positives, but ignoring it completely would introduce a huge source of false negatives. However, I do think the issue should be discussed in reports of findings. Larry Burnett wrote: As I remember the discussion which included authors from the study, led to the realization that DMF included all the fillings that were medically unnecessary. That little "glitch" was actually hundreds of millions of dollars of overtreatment which made the caries incidence look much worse than reality. As a matter of fact. Those involved in the study agreed that DMF for those purposes should list decayed and missing and drop the filled from the criteria. Of course, that was the end of it. Do you remember that, and are you still on it? -- Phil Swango 307 Aliso Dr SE Albuquerque, NM 87108 505-262-4085