Making the Grade? Modification of Dental Radiograph Quality Ratings

Author:

Rodgers George D1,Sharif Mohammad O2,Smith Adam B3,Kellett Margaret3,Brunton Paul A3

Affiliation:

1. General Dental Practitioner, Wigan, Lancashire, UK.

2. National Institute for Health Research Academic Clinical Fellowship (Orthodontics). Oral Health Unit, School of Dentistry, University of Manchester, Manchester, UK.

3. Leeds Dental Institute, University of Leeds, UK.

Abstract

Aims To compare the intra- and inter-assessor agreement and operator preference of a modified (four-grade) quality rating system for dental radiographs with the current National Radiological Protection Board (NRPB) (three-grade) quality rating system. Methods Sixty radiographic images of varying quality were selected by retrospective review of dental records from a general dental practice. The images were sorted into groups to represent examples of radiographic quality (1=excellent, 2=diagnostically acceptable, 3=diagnostically compromised, 4=unacceptable). A ‘gold standard’ for radiological quality assessment was provided by a consultant in dental and maxillofacial radiology. A compact disc (CD) of the 60 images was produced and posted to a panel of 14 general dental practitioners (GDPs) who were asked to grade the quality of the images using two different systems on two occasions separated by a washout period of two days. The practitioners graded the radiographs using the currently accepted method for assessing radiographic quality (the three-grade NRPB system) and the alternative four-grade system. The quality of the images on the CD was deemed appropriate by the consultant. Results The strength of inter-assessor agreement was weaker when using a four-grade system in comparison to a three-grade system, reducing to a mean of κ=0.51 from a mean of κ=0.61 when using the original grading system. Mean agreement did not fall below ‘moderate agreement’ (κ=0.41–0.60). Eleven of the 14 GDPs preferred the four-grade system. Conclusion The GDPs who participated in this study preferred the four-grade system to the three-grade system when comparing the quality of dental radiographs. However, the strength of agreement was weaker when using the four-grade system in comparison to the three-grade system. Overall, the results are equivocal. However, they should help to inform specialist dental radiology panels, should revision of quality grading be undertaken in the future.

Publisher

SAGE Publications

Subject

General Medicine

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