Reporte de una metodología de calibración de examinadores en el uso del Sistema Internacional de Detección y Valoración de Caries (ICDAS) / Report of a method for the calibration of examiners in the International Caries Detection and Assessment System
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RESUMEN. Antecedentes: El Sistema Internacional de Detección y Valoración de Caries ICDAS (International Caries Detection and Assessment System) se enmarca en el entendimiento actual de caries y se utiliza de forma amplia en clínica, investigación y educación. UNICA- la Unidad de Investigación en Caries de la Universidad El Bosque, tiene más de 10 años de experiencia en el uso y enseñanza del sistema y ha calibrado más de 100 examinadores nacionales e internacionales. Objetivo: Con el fin de seguir ampliando el uso de ICDAS, el propósito de este estudio es reportar una metodología de calibración (adaptable también para el entrenamiento de examinadores clínicos) utilizada durante la preparación del estudio “Perfil epidemiológico sobre caries dental, riesgo y calidad de vida y, aspectos del examen dental, en niños de 12 a 71 meses de estrato socio-económico bajo de Bogotá”. Métodos: La calibración de examinadores constó de una fase de preparación del entrenamiento y de los examinadores y una fase de desarrollo del curso/calibración, incluyendo sesión teórica, prácticas pre-clínica y clínica, exámenes clínicos de los examinadores y, discusión de los resultados de la calibración. Resultados: Participaron 9 examinadores y 18 pacientes. El examinador estándar clasificó 1473 sitios/superficies de examen y cada examinador en promedio 581,33 (DE 136,76) sitios/superficies. Los valores kappa de reproducibilidad interexaminador fueron en promedio de 0,72 (DE 0,02) e intraexaminador 0,74 (DE 0,08). Conclusiones: Esta calibración fue exitosa y se espera que como entrenamiento sea multiplicador del uso del sistema ICDAS en Latinoamérica.
ABSTRACT. Background: The International Caries Detection and Assessment System ICDAS diagnostic system follows the current caries understanding and it is broadly used in the clinics, research and education. UNICA- the Caries Research Unit at Universidad El Bosque has more than 10 years of experience in the use and teaching of the ICDAS system, and has calibrated more than 100 national and international examiners. Purpose: Aiming at continuing spreading the use of ICDAS, the purpose of this study is to report a methodology for calibration of examiners (adaptable for training of clinicians as well) used during the preparation of the study “Epidemiologic profile of dental caries, risk and quality of life, and dental examination aspects in 12 to 71-month old low-socioeconomic status children from Bogotá.” Methods: The examiners’ calibration includes training and examiners’ preparation phase and a course/calibration development phase, including theoretic session, pre-clinical and clinical practice, examiners’ clinical assessments, and calibration results discussion. Results: 9 examiners and 18 patients participated. The standard examiner classified 1473 examination sites/surfaces and each examiner a mean of 581.33 (SD 136.76) sites/surfaces. The inter- and intra-examiner reproducibility kappa values were in mean of 0.72 (SD 0.02) and 0.74 (DE 0.08), respectively. Conclusions: This calibration was successful and it is expected that as training can have a multiplying effect on the use of ICDAS in Latin America.
calibración, caries dental, cariología, diagnóstico, educación dental, ICDAS, reproducibilidad de resultados
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