摘要
目的验证正畸治疗难度、结果、需要指数(Index of treatment complexity,outcome and need,ICON)在新疆地区的可靠性及有效性,为新疆地区正畸治疗提供帮助。方法选取新疆石河子地区在校学生254名制取模型,由专业人员按照ICON标准对模型进行正畸治疗需要评分,所得结果与该地区6名正畸专家构成的专家组决定进行比较。结果不论是ICON测量者、专家组,还是ICON与专家组"金标准",Kappa值均大于0.80具有较高一致性,表明ICON可以反映新疆地区正畸医师决策。通过ROC曲线评价ICON,其标准截止点与优化截止点的灵敏度、特异度、准确度分别为(93.6%、79.5%、86.8%)和(89.4%、90.9%、90.1%),表明ICON具有良好的诊断效能,但ICON应用于新疆时应考虑地区治疗需要量较低而优化截止点,提高准确度。结论在新疆地区应用ICON指数能够正确的反映正畸医生的决策,且具有较高的诊断效能,但要注意其最佳治疗需要截止点受地域影响。应用ICON确定正畸治疗需要使诊断过程简化将是正畸学未来的发展方向。
Objective To verify the reliability and effectiveness of the index of treatment complexity, outcome and need(ICON) in Xinjiang and to provide assistance for orthodontic treatment in Xinjiang.Methods A total of 254 students in Shihezi area of Xinjiang were selected to make the model. Professionals scored the needs of orthodontic treatment according to ICON standard. The results were compared with the decision of the expert group composed of six orthodontists in this area.Results Whether it is ICON measurer, expert group, or ICON and expert group "gold standard", Kappa value is higher than 0.80 with high consistency, indicating that ICON can reflect the orthodontist decision in Xinjiang.Evaluation of ICON by ROC curve,the sensitivity, specificity and accuracy of the standard cut-off point and the optimized cut-off point are(93.6%, 79.5%, 86.8%) and(89.4%, 90.9%, 90.1%), respectively, indicating that ICON has good diagnostic performance.However, when ICON is applied to Xinjiang, it should consider the lower regional treatment needs and optimize the cut-off point to improve accuracy.Conclusion The application of the ICON index in Xinjiang can correctly reflect the orthodontist’s decision-making and has a high diagnostic efficiency, but it should be noted that the best treatment needs the cut-off point to be affected by the region.
作者
吕锡旌
李启期
陈敏
焦海霞
LYU Xi-jing;LI Qi-qi;CHEN Min;JIAO Hai-xia(Department of Stomatology,The first Affiliated Hospital of college of Medicine of Shihezi University,Shihezi,Xinjiang 832000,China)
出处
《医药论坛杂志》
2020年第11期73-76,共4页
Journal of Medical Forum
