Introdução à Medicina Validity of remote dental diagnosis of children by medical students.

Introdução à MedicinaIntrodução à Medicina

Validity of remote dental Validity of remote dental diagnosis of children by diagnosis of children by

medical studentsmedical students


IntroductionIntroduction

Portuguese children oral health care is deficientPortuguese children oral health care is deficient

Dental Caries Prevalence

Have dental caries

Have no dental caries

Fist dentist consultation

After 6 years old

Until 6 years old

49% have dental caries (by Direcção-Geral de Saúde)*49% have dental caries (by Direcção-Geral de Saúde)*

56% never went to the dentist (by Sociedade Portuguesa de Estomatologia 56% never went to the dentist (by Sociedade Portuguesa de Estomatologia e Medicina Dentária)*e Medicina Dentária)*

*References in last References in last slideslide


IntroductionIntroduction

Telemedicine using Telemedicine using low-cost and widespread low-cost and widespread technologytechnology

Our study is based on Dr Rui Amável’s studyOur study is based on Dr Rui Amável’s study

What is the reproducibility and What is the reproducibility and validity of remote diagnosis by first validity of remote diagnosis by first

year medical students using year medical students using photographs as a method of photographs as a method of screening children's dental screening children's dental

problems?problems?


Participants and MethodsParticipants and Methods


Study designStudy design

Target-population - first year medical students of Target-population - first year medical students of Universidade do PortoUniversidade do Porto

ObservationalObservational

TransversalTransversal

AnalyticalAnalytical

Unit of study – photographsUnit of study – photographs

Diagnosis method evaluation studyDiagnosis method evaluation study


Data collectionData collection

PhotographsPhotographs

Sixty six childrenSixty six children

Three photos for each childThree photos for each child

Dr Rui Amável’s criteriaDr Rui Amável’s criteria


Data collectionData collection

QuestionnaireQuestionnaire filling filling

Recognition of necessity of specialist’s attendanceRecognition of necessity of specialist’s attendance


Statistical AnalysisStatistical Analysis Divide the photos for three disjoint sets (22 Divide the photos for three disjoint sets (22

children for each):children for each): I, II and III I, II and III

Two groups of 4 students (A and B) and one of 5 Two groups of 4 students (A and B) and one of 5 (C). (13 class members)(C). (13 class members)

Comparison of the two Comparison of the two stagesstages

Intra observer agreementIntra observer agreement

Inter observer agreementInter observer agreement

Correction rateCorrection rate

SensibilitySensibility

SpecificitySpecificity

Comparison with specialistsComparison with specialists

Stage 1Stage 1Group A: Set IGroup A: Set I

Group B: Set IIGroup B: Set II

Group C: Set IIIGroup C: Set III

Stage 2Stage 2Group A: Set IIGroup A: Set II

Group B: Set IIIGroup B: Set III

Group C: Set IGroup C: Set I


FlowchartFlowchartBeginning

Read 1st analysis of the first stage

Read 2nd analysis of the first stage

Intra-observer agreement rate

Inter-observer agreement rate

Read Gold Standard


FlowchartFlowchart

End

Compare 1st and 2nd analysis with Gold Standard

Specificity and Sensibility

Record results and conclusions

Explore errors

Read 1st and 2nd analysis of the second stage


Gantt chartGantt chart

1.1. Formation with Dr Rui Amável Formation with Dr Rui Amável

2.2. First analysis of the first stage First analysis of the first stage

3.3. Second analysis of the first stage Second analysis of the first stage

4.4. Comparison of the results Comparison of the results

5.5. First analysis of the second stage First analysis of the second stage

6.6. Second analysis of the second stage Second analysis of the second stage

7.7. Comparison of the results Comparison of the results


Expected ResultsExpected Results

First year medical students are able to First year medical students are able to recognize the necessity of specialist’s recognize the necessity of specialist’s

attendance only by looking at children mouths’ attendance only by looking at children mouths’ photos…photos…


ReferencesReferencesLeao JC, Porter SR. Telediagnosis of oral disease. Department of Oral Medicine, Eastman Leao JC, Porter SR. Telediagnosis of oral disease. Department of Oral Medicine, Eastman Dental Institute for Oral Health Care Sciences, University of London, England. Dental Institute for Oral Health Care Sciences, University of London, England. PMID: PMID: 10863389 Pubmed 10863389 Pubmed Almeida CM, Petersen PE, André SJ, Toscano A. Changing oral health status of 6- and 12-Almeida CM, Petersen PE, André SJ, Toscano A. Changing oral health status of 6- and 12-year-old schoolchildren in Portugal. Department for Community Dental Health, Faculty year-old schoolchildren in Portugal. Department for Community Dental Health, Faculty of Dental Medicine, University of Lisbon, Portugal. PMID: 14696739 PubMed of Dental Medicine, University of Lisbon, Portugal. PMID: 14696739 PubMed Rui Amável, José Bulhosa, Ricardo Cruz-Correia. Rui Amável, José Bulhosa, Ricardo Cruz-Correia. Potencial of teledentistry in the early Potencial of teledentistry in the early diagnosis of caries. diagnosis of caries. Proceedings of the 1st Medical Informatics Symposium. 2008 Proceedings of the 1st Medical Informatics Symposium. 2008 Programa "Mês da Saúde Oral" da Colgate Portugal e SPEMD - Relatório Estatístico de Programa "Mês da Saúde Oral" da Colgate Portugal e SPEMD - Relatório Estatístico de Set.2006. Set.2006. (2006). Retrieved Fev 2008, from (2006). Retrieved Fev 2008, from http://http://www.spemd.pt/indexRastreios.htmlwww.spemd.pt/indexRastreios.html Wheeler, T. (1999). Smile for the camera: telemedicine comes to your local dentist's Wheeler, T. (1999). Smile for the camera: telemedicine comes to your local dentist's office. office. Telemed Today, 14(5), 42. Telemed Today, 14(5), 42. Ministério da Saúde. (2008). Estudo Nacional de Prevalência das Doenças Orais. Ministério da Saúde. (2008). Estudo Nacional de Prevalência das Doenças Orais. Lisboa. Lisboa. Shortliffe, E., & Cimino, J. (2006). Biomedical Informatics – Computer Applications in Shortliffe, E., & Cimino, J. (2006). Biomedical Informatics – Computer Applications in Health Care and Biomedicine (3rd ed.): Springer Health Care and Biomedicine (3rd ed.): Springer Sociedade Portuguesa de Estomatologia e Medicina Dentária. Sociedade Portuguesa de Estomatologia e Medicina Dentária. (2007). Newsletter nº6: (2007). Newsletter nº6: Colgate Palmolive Colgate Palmolive AMG, C. (1994). AMG, C. (1994). Contribuição para o estudo da prevalência e da gravidade da cárie Contribuição para o estudo da prevalência e da gravidade da cárie dentária nos dentes temporários das crianças portuguesas. Universidade do Porto, Porto dentária nos dentes temporários das crianças portuguesas. Universidade do Porto, Porto Bashshur, R., Sanders, J., & Shannon, G. (1997). Bashshur, R., Sanders, J., & Shannon, G. (1997). Telemedicine: Theory and practice. Telemedicine: Theory and practice. Springfield, IL. Springfield, IL.

Introdução à Medicina Validity of remote dental diagnosis of children by medical students.

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