Sequential Test Selection by Quantifying of the Reduction in Diagnostic Uncertainty for the Diagnosis of Proximal Caries

摘要

Background: In order to determine the presence or absence of a certain disease, multiple diagnostic tests may be necessary. Performance of these tests can be sequentially evaluated. Aims: The aim of the study is to determine the contribution of the test in each step, in reducing diagnostic uncertainty when multiple tests are sequentially used for the diagnosis. Study Design: Diagnostic accuracy study Methods: Radiographs of seventy-three patients of the Department of Dento-Maxillofacial Radiology of Hacettepe University Faculty of Dentistry were assessed. Panoramic (PAN), full mouth intraoral (FM), and bitewing (BW) radiographs were used for the diagnosis of proximal caries in the maxillary and mandibular molar regions. Diagnostic performance of radiography was sequentially evaluated by using the reduction in diagnostic uncertainty. Results: FM provided maximum diagnostic information for ruling in potential in the maxillary and mandibular molar regions in the first step. FM provided more diagnostic information than BW radiographs for ruling in the mandibular region in the second step. In the mandibular region, BW radiographs provided more diagnostic information than FM for ruling out in the first step. Conclusion: The presented method in this study provides the clinicians with a solution for the decision of the sequential selection of diagnostic tests for the correct diagnosis of the presence or absence of a certain disease. Turkish Ba?l?k: Arayüz ?ürüklerinin Tan?s? i?in Tan? Belirsizli?indeki Azalma ?l?ülerek Ard???k Test Se?imi Anahtar Kelimeler: Test s?ras?, belirsizlikteki azalma, ara yüz ?ürükleri, radyografik y?ntemler Arka Plan: Belirli bir hastal???n varl???n? ya da yoklu?unu g?stermek i?in ?oklu tan? testi kullanmak gerekebilir. Bu testlerin performans? ard???k de?erlendirilebilir. Ama?: Bu ?al??man?n amac?, tan? i?in birden fazla test ard???k kullan?ld???nda, her bir ad?mda tan? belirsizli?ini azaltmada testin katk?s?n? belirlemektir. ?al??ma Tasar?m?: Tan?sal kesinlik ?al??mas?. Y?ntemler: ?al??mada Hacettepe üniversitesi A??z, Di? ve ?ene Radyoloji B?lümü'ne ba?vuran 73 hastan?n radyograflar? de?erlendirilmi?tir. Panoramik (PAN), tüm a??z intraoral (FM) ve bitewing (BW) radyograflar maksiller and mandibular molar b?lgedeki arayüz ?ürüklerinin belirlenmesinde kullan?lm??t?r. Ard???k kullan?lan radyograflar?n tan? performanslar?, tan? belirsizli?indeki azalma kullan?larak de?erlendirilmi?tir. Bulgular: ?ürük varl???n?n g?sterilmesinde birinci ad?mda, FM maksiller ve mandibular b?lge i?in en fazla tan? bilgisine sahiptir. Mandibular b?lge i?in ikinci ad?mda, ?ürük varl???n? g?stermede, FM, BW'den daha fazla tan? bilgisine sahiptir. Mandibular b?lge i?in ?ürük yoklu?unu g?stermede, ilk ad?mda BW, FM 'den daha fazla bilgi sa?lam??t?r. Sonu?: Bu ?al??mada sunulan y?ntem, belirli bir hastal???n varl??? ya da yoklu?u konusunda do?ru tan? koyabilmek i?in ard???k kullan?lacak olan testin se?iminde klinisyenlere bir ??züm sunmaktad?r.