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Are photographic records reliable for orthodontic screening?

University Dental Hospital of Manchester, UK

Correspondence: Dr N. A. Mandall, Department of Oral Health and Development, University Dental Hospital of Manchester, Higher Cambridge Street, Manchester M15 6FH, UK. Email: mdtmsnam{at}fs1.den.man.ac.uk

Abstract

Aim: The aim of the study was to evaluate the reliability of a panel of orthodontists for accepting new patient referrals based on clinical photographs.

Sample: Eight orthodontists from Greater Manchester, Lancashire, Chester, and Derbyshire observed clinical photographs of 40 consecutive new patients attending the orthodontic department, Hope Hospital, Salford.

Method: They recorded whether or not they would accept the patient, as a new patient referral, in their department. Each consultant was asked to take into account factors, such as oral hygiene, dental development, and severity of the malocclusion.

Statistics: Kappa statistic for multiple-rater agreement and kappa statistic for intra-observer reliability were calculated.

Results: Inter-observer panel agreement for accepting new patient referrals based on photographic information was low (multiple rater kappa score 0.37). Intra-examiner agreement was better (kappa range 0.34–0.90).

Conclusion: Clinician agreement for screening and accepting orthodontic referrals based on clinical photographs is comparable to that previously reported for other clinical decision making.

Key words: Clinical photographs, consultant reliability, inappropriate referrals, new patient referrals

Co-investigators: D. Bearn, S. Chadwick, D. Hegarty, D. H. Lewis, C. R. Mattick, J. Sandler, M. Trenouth, K. D. O'Brien.

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