Inter-examiner Calibration Study using ICDAS in University Dental Clinic

Aim: This study aimed to evaluate the reproducibility of the ICDAS visual classification system in clinical setting along with conventional dental charting. Materials and methods: Thirty adult patients attending SEGI University dental clinic were screened using ICDAS detection codes along with conventional dental charting. Three clinicians, 2 Dental Public Health Specialists (KCG, DD) and 1 Oral Medicine specialist (AM) with previous training in ICDAS, screened these patients separately under same clinical setting. The teeth were visually examined after air-drying with 3 way syringe and the codes per tooth were recorded on new clinical chart which includes ICDAS score per tooth and conventional dental chart. Kappa analysis was done to calculate the inter-examiner reproducibility. Results: Kappa values for inter-examiner reproducibility were calculated to assess reproducibility of the examiners. The inter-examiner reproducibility between KCG-DD ranged from 0.775 to 0.852, from 0.740 to 0.827 between AM-DD and from 0.768 to 0.849 between observers KCG-AM. The time difference in the charting was found to be not significant Conclusion: The ICDAS system has demonstrated reproducibility and diagnostic accuracy for the detection of caries at varying stages of the disease process. Combining conventional dental charting along with ICDAS showed no significant time difference in charting. The ICDAS system achieved substantial to good agreement between examiners, is practical in clinical dental practice with training and can be improved with experience. Keywords: ICDAS, inter-examiner, calibration