Comparative evaluation of three different recording criteria of dental fluorosis in a known endemic fluoride area of Haryana

Background & objectives: Various indices are available to record different grade of severity of dental fluorosis. These indices have chances of inter- and intra- examiner variability. Therefore, study was conducted to compare three different indices for recording dental fluorosis to find out the best and most practical index of recording dental fluorosis for field studies in children living in a fluoride endemic area. Methods: The severity grades were recorded in 300 schoolchildren aged 12-15 yr having dental fluorosis of low, medium and high fluoride areas using three different indices, viz. Dean's fluorosis index (1942), tooth surface index for fluorosis (TSIF, 1984) and ICMR index (2013). Dean's index was used as gold standard. Results: The occurrence of moderate and severe cases was higher as per the Dean's index and of mild and severe cases was higher as per the TSIF and the ICMR index. The mean time required for recording dental fluorosis as per Dean's index and TSIF was similar and almost double (1.25�05 min) of that required for ICMR index (0.68�20 min). The intra-examiner variability was found to be least in the ICMR index compared to Dean's index and TSIF. Interpretation & conclusions: The ICMR index is a simple index with objective scores and takes less time in recording the dental fluorosis as compared to Dean's index and TSIF in field studies.

Validation of ICMR index for identification of dental fluorosis in epidemiological studies.

Background & objectives: The Indian Council of Medical Research (ICMR) formulated a Task Force on dental fluorosis and recommended the subgroup to develop a simplified index for identification and grading of dental fluorosis to be used by the health workers. This study was conducted to pre-test the ‘ICMR Index for Dental Fluorosis’ in the field to check its reliability and reproducibility. Methods: A total of 600 photographs were taken, 150 in each grade of fluorosis by screening 14-17 yr school children from eight schools of Hisar (Haryana) and South west Delhi. Eighty photographs were finalized (20 in each grade) before calibration to be used for training of field workers. Calibration exercise was conducted involving the five member survey team on 100 diagnosed cases of dental fluorosis. The members again screened 74 children with dental fluorosis in the field to categorize in to different grades of fluorosis for assessment of inter-examiner reliability. Results: The ICMR criteria showed more difference in agreement in very mild and mild categories during calibration. The inter-examiner reliability (κ) ranged from 0.59-1. The criteria was further modified and inter- examiner reliability (κ) found to be 0.83-0.98 which was almost perfect agreement. Interpretation & conclusions: The tool developed by the ICMR to assess dental fluorosis can be used in a field set up by non-dental personnel reliably with high degree of reproducibility.

Comparison between denture wearer's evaluation and clinician's rating for complete denture / 대한치과보철학회지

PURPOSE: The aim of this study was to compare denture wearer's evaluation and clinician's technical rating for complete denture used on edentulous patients. MATERIALS AND METHODS: Total 43 edentulous patients who had complete denture fabricated more than one year ago were recalled. The questionnaire based on the various literatures was modified and applied to patients for subjective assessments. Functional aspects related to retention, stability, occlusion and denture condition were included in operator's evaluation. In addition, correlations were evaluated between patient's subjective and operator's objective assessments. Friedman test and Cohen's Kappa value were used for statistical analysis. RESULTS: It was found that denture wearers' evaluations were slightly or fairly agree to clinician's rating for complete denture. More differences were found in maxillary denture than mandibular denture and moderate difference was found in esthetic, occlusion aspects. CONCLUSION: There were slightly or fairly agreement between subjective and objective evaluations.

Application Evaluation of Prescription Comment Software in Our Hospital / 中国药房

OBJECTIVE:To evaluate the application of prescription comment software in our hospital. METHODS:552 pre-scriptions were evaluated by pharmacist A,B and software,and the Kappa values were calculated to evaluate the reliability of the software. The results of comment by pharmacist B and by software were combined (serial test and parallel test),and then com-pared with the results of comment by pharmacist A. The sensitivity,specificity and Youden's index were calculated to evaluate the reliability of the software. The comment results of 552 prescriptions by pharmacist A for twice were compared to calculate Kappa value,and it was used to evaluate the comment consistency of pharmacist A. RESULTS:The pharmacist A,B comment results and software comment results showed poor consistency,and Kappa value were 0.020 2 and 0.002 0,with significant difference (P<0.001);pharmacist A comment results had strongest consistency with pharmacist B comment results,and Kappa value was 0.843 0,with no significant difference(0.1

A Comparison of Three Diagnostic Criterions for Metabolic Syndrome Applied in Population of Xilinhaote City / 中国慢性病预防与控制

Objective To compare the differences of three diagnostic criterions for metabolic syndrome (MS) proposed by the International Diabetes Federation (IDF) in 2005, the Third Report of National Cholesterol Education Program-Adult Treatment Panel Ⅲ (NCEP-ATPⅢ) in 2005 and Chinese Diabetes Society(CDS)in 2004 in population of Xilinguole city in inner mongolia. Methods 1 060 employees aged more than 20 yrs in enterprises taken health examination in Xilinguole hospital were investigated by epidemiological survey and the prevalence rates of MS and its components were calculated according to these three definitions respectively, and compared the agreement rates and difference between these definitions. Results The age-adjusted MS prevalence rates were 25.0%, 27.9% and 22.5% according to IDF (2005), ATPⅢ (2005) and CDS (2004) respectively. The agreement rate of diagnosis between IDF and ATPⅢ was the highest, and the Kappa value was 0.929. The kappa values between IDF and CDS,ATPⅢ and CDS were 0.726 and 0.763, respectively. There were 4.3% and 10.8% subjects respectively without MS diagnosed by IDF and CDS criterion presented at least 3 risk factors respectively. For Mongolia nationality people, when the waist circumference was 90cm in male and BMI was 25kg/m2 in female, the sensitivity and specificity were relative better, and the distance of ROC curve was the shortest, but for Han nationality, BMI≥25 kg / m2 in male and waist circumference ≥80 cm was better. Conclusion ATPⅢ definition can screen out the highest prevalence of MS and risk factors aggregation among three definitions, and it's best for screening for the high risk population of cardio-cerebrovascular diseases. The cutoff value of waist circumference (WC) in IDF and ATP Ⅲ seems better for Mongolia nationality men; while the cutoff value in CDS was better for Han nationality men. We should combine waist circumference and body mass index to judge the condition of obesity.

Interobserver Variability in Interpretation of Mammogram

PURPOSE: The purpose of this study was to evaluate the performance of radiologists for mammographic screening, and to analyze interobserver agreement in the interpretation of mammograms. MATERIALS AND METHODS: 50 women were selected as subjects from the patients who were screened with mammograms at two university hospitals. The images were analyzed by five radiologists working independently and without their having any knowledge of the final diagnosis. The interobserver variation was analyzed by using the kappa statistic. RESULTS: There were moderate agreements for the findings of the parenchymal pattern (k=0.44; 95% CI 0.39-0.49), calcification type (k=0.66; 95% CI 0.60-0.72) and calcification distribution (k=0.43; 95% CI 0.38-0.48). The mean kappa values ranged from 0.66 to 0.42 for the mass findings. The mean kappa value for the final conclusion was 0.44 (95% CI 0.38-0.51). In general, moderate agreement was evident for all the categories that were evaluated. CONCLUSION: The general agreement was moderate, but there was wide variability in some findings. To improve the accuracy and reduce variability among physicians in interpretation, proper training of radiologists and standardization of criteria are essential for breast screening.

Comparative consistency between obesity determination standards using Body Mass Index and Ideal body weight

BACKGROUND: Ideal Body Weight(IBW) is commonly used to determine obesity levels because of its usefulness as target weight. This study was attempted to evaluate the comparative consistency between standards of determining obesity levels using the BMI and IBW. And the authors here provide a definition of IBW and attempt to suggest a new classification of obesity by IBW. METHODS: The test subjects for the research were 24,816 patients who received treatment at the SNUH Health Promotion Center between May 1, 1996 and December 31, 1999. The comparative consistency between standards of determining obesity levels using the BMI and IBW were analyzed calculating the kappa value. RESULTS: The IBW from the Broca method produced a kappa value of 0.668(p<0.001), while the calculation method for IBW recommended by the Japan Obesity Institute produced a kappa value of 0.664(p<0.001). On the other hand, an IBW calculated as 21(kg/m2)X[height(m)]2 (kg) produced the highest value of consistency at a kappa value of 0.911(p<0.001). After calculating IBW as 21(kg/m2)X[height(m)]2 (kg) and comparing the kappa values while adjusting the boundary zone standards, it was found that defining underweight as below 88% of IBW and obesity as above 145% produced the highest value of concurrence at a kappa value of 0.935(p<0.001). CONCLUSION: The validity and confidence with respect to the definition of IBW and the determination method for obesity as proposed by the authors may be confirmed through the methods high level of consistency [kappa value=0.935(p<0.001)] with determination methods using the BMI.