Visual and radiographic caries detection: A tailored meta-analysis for two different settings, Egypt and Germany

• Main Authors: El Shahawy, O. (Author), Elhennawy, K. (Author), Gimenez, T. (Author), Maher, R. (Author), Mendes, F.M (Author), Schwendicke, F. (Author), Willis, B.H (Author)
• Format: Article
• Language: English
• Published: BioMed Central Ltd. 2018
• Subjects: adolescent; Adolescent; Caries detection; child; Child; Decision making; dental caries; Dental Caries; Diagnostic accuracy studies; diagnostic imaging; Egypt; Evidence-based dentistry; Germany; human; Humans; Medical informatics; meta analysis; Radiography, Dental; tooth radiography
• Online Access: View Fulltext in Publisher

 Background: Diagnostic meta-analyses on caries detection methods should assist practitioners in their daily practice. However, conventional meta-analysis estimates may be inapplicable due to differences in test conduct, applied thresholds and assessed population between settings. Our aim was to demonstrate the impact of tailored meta-analysis of visual and radiographic caries detection to different settings using setting-specific routine data. Methods: Published systematic reviews and meta-analyses on the accuracy of visual and radiographic caries detection were used. In two settings (a private practice in Germany and a public health clinic in Egypt), routine data of a total of 100 (n=50/practice) consecutive 12-14year-olds were collected. Test-positive rates of visual and radiographic detection for initial and advanced carious lesions on occlusal or proximal surfaces of molars were used to tailor meta-analyses. If prevalence data were available, these were also used for tailoring. Results: From the original reviews, 210 and 100 heterogeneous studies on visual and radiographic caries detection were included in our meta-analyses. For radiographic detection, sensitivity and specificity estimates derived from conventional and tailored meta-analysis were similar. For visual detection of advanced occlusal carious lesions, the conventional meta-analysis yielded a sensitivity and specificity (95% CI) of 64.6% (57-71) and 90.9% (88-93), whereas the tailored estimates for Egypt were 75.1% (70-81) and 84.9% (82-89), respectively, and 43.7% (37-51) and 96.5% (95-97) for Germany, respectively. Conclusion: Conventional test accuracy meta-analyses may yield aggregate estimates which are inapplicable to specific settings. Routine data may be used to produce a meta-analysis estimate which is tailored to the setting and thereby improving its applicability. © 2018 The Author(s).