Abstract
PurposeTo study general dental practitioners (GDPs) ability to detect calcified carotid artery atheromas (CCAAs) in panoramic radiographs (PRs) and if their diagnostic accuracy in long term is improved after a short training programme.MethodsFourteen GDPs had their diagnostic accuracy regarding CCAA in PR assessed at baseline, 2 weeks and 1 year after training. Comparison was made with a reference standard based on consensus results from two experienced oral and maxillofacial radiologists. At each session, 100 radiographs were assessed individually by the GDPs. After the baseline assessment, the GDPs participated in a 2‐hour training programme comprising a lecture and diagnostic training by calibration. The GDPs results before and after training were compared, as well as between follow‐up sessions.ResultsA significant improvement in diagnostic accuracy was observed with increased sensitivity (from 41.8% to 55.7%, P = 0.02) without a significant decrease in specificity (from 87.2% to 86.7%, P = 0.87). The Kappa values also increased (from 0.66 to 0.71, P = 0.04). At 1‐year follow‐up, the improvement compared to baseline remained significant. There were no significant changes between the 2‐week and 1‐year follow‐up assessment.ConclusionA short training programme can significantly and sustainable improve GDPs diagnostic accuracy regarding CCAA.
Highlights
According to the World Health Organization, heart disease and stroke are the two most common causes of death in the world in both middle‐ and high‐income countries,[1] and can be prevented if detected early.[2]Many studies over the past decades have evaluated the diagnos‐ tic value of identifying calcified carotid artery atheromas (CCAAs) on panoramic radiographs (PRs) as a base for decisions regarding need for preventive treatment. (Figure 1)
All radiographs were assessed by two experienced specialists in oral and maxillofacial radiology (OMFR) (ELJ and JA), who previously had calibrated their assess‐ ments of CCAA in PRs to a high degree of agreement compared with computed tomography angiography and examinations of extirpated plaques
Our results indicate that general dental practitioners (GDPs) have a low risk of false positive as‐ sessments even without specific training in CCAA diagnostics
Summary
According to the World Health Organization, heart disease and stroke are the two most common causes of death in the world in both middle‐ and high‐income countries,[1] and can be prevented if detected early.[2]. Implementation of diagnosing CCAA in general dentistry is desirable but requires that the GDPs have a high diagnostic accuracy, detecting high‐risk individuals with as few false positives as possible since that will burden the health care system without increasing survival.[9] To facilitate that, GDPs need education and practice in diagnosing CCAA to gain high accuracy, with high specificity. The study did not include a long‐term follow‐up.[16] Short training programmes including practical training have been shown to be effective to increased accuracy in diagnostic imaging among GDPs assessing osseous changes in the tempomandibular joint on Cone Beam Computer Tomography[24] and among dental students assessing osteoporosis in dental radiographs.[25] Similar results have been reported for physicians when assessing pneumonia on chest radiographs[26] and novices trained in doppler assessments of the intima thickness of the carotid artery.[27] GDPs in general have a positive attitude to continuing education activities and find them beneficial and effective in improving their clinical practice.[28]. Our objective was as follows (i) to assess GDPs’ ability to detect CCAAs on PRs compared to consensus of two specialists in OMFR; (ii) to determine whether GDPs’ diagnostic abilities can be improved by means of a short, two‐hour training programme, including a lec‐ ture and practical training with calibration of diagnosing and (iii) to investigate if improvements achieved in diagnostic accuracy are re‐ tained over time
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Schedule a callMore From: European journal of dental education : official journal of the Association for Dental Education in Europe
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