Dissertation

Satisfaction of Search in Periapical Radiographs

Huynh, Johnny D

2020

Overview

Introduction: Several studies in radiology and medicine have evaluated the satisfaction of search error effect in chest radiography, abdominal radiography, osteoradiology, and patients with multiple trauma. No research to date exists evaluating the possible existence of the satisfaction of search error phenomenon during dental periapical radiograph interpretations.Purpose: The purpose of this study was to determine if there exists a satisfaction of search error effect when dental clinicians interpret periapical radiographs. The null hypothesis is that the detection accuracy will be the same or will improve for the detection of native lesions in the presence of an added abnormality. The alternative hypothesis is that there will be a decrease in detection accuracy for native lesions in the presence of an added abnormality.Materials and Methods: Six images were selected to be part of the present experiment. One of the six images served as the positive control and another image served as the negative control. Four images, each including a single subtle carious lesion, were selected to represent the experimental images. The single subtle carious lesion present within the four experimental radiographs served as the native pathology, and an abnormality such as a periapical radiolucency, resorption, inadequate non-ideal root canal obturation material, or recurrent carious lesion was artificially inserted into the image as the added pathology. Thus, the second set of images consisted of the same four images containing the native pathology including an added pathology that was inserted into the image using Adobe Photoshop CS6 (Adobe, Inc., San Jose, CA).Purposive sampling was obtained from 16 examiners that included residents from endodontics and periodontics, as well as alumni and faculty from the Saint Louis University Center for Advanced Dental Education. Each observer participated as a subject during two, time-separated sessions. Each session was separated by a minimum period of three months duration, in order to prevent memory bias. Before starting each interpretation session, the participants were given verbal instructions. Subjects were instructed to provide a location (by tooth number), identify and rate the presence of all suspected pathology using a Likert scale of 1-5: (1: Definitely normal, 2: Probably normal, 3: Possibly abnormal, 4: Probably abnormal, 5: Definitely abnormal). In the second session, the radiographs that were initially presented containing only the native lesion were presented again with the added abnormality, and vice versa. The observer’s reports and confidence ratings were recorded and analyzed. Ratings of 3-5 were considered as being positive for the presence of pathology.Results: A true satisfaction of search (SOS) error occurs when the presence of the native lesion is reported correctly without an added abnormality, but is not reported (missed) in the presence of an added abnormality. In our study, a true SOS error occurred in 13 of the 64 interpretation sets (20.31%). There was a total of 64 expected native lesions present within the 4 native images viewed by 16 observers. In the 4 four added images, there was a total of 64 expected added findings. In the images with containing only native lesions, the observers reported 30 of the 64 expected native lesions. In the images containing an artificially added abnormality, the observers reported 58 of the 64 expected added abnormalities and 25 of the 64 expected native lesions. Observers reported fewer native lesions in the presence of an added abnormality.Conclusion: The current investigation demonstrated the existence of the satisfaction of search effect during periapical radiographic interpretations. In 20.31% of interpretations, a true SOS error occurred. This study is clinically relevant because it can help clinicians in reducing false-negative errors made during radiographic interpretation, thus preventing misdiagnosis.

• Publisher: ProQuest Dissertations & Theses
• Subject: Dentistry
• ISBN: 9798662599987