Evidence map›Paper›PMID 39647994›Full record

Trial reportJournal of public health dentistry2025

Training protocol and calibration of the International Caries Detection and Assessment System in a school-based clinical trial of elementary school-age children.

Jose-Miguel Yamal, Dania Mofleh, Ru-Jye Chuang, Mengxi Wang, Kila Johnson, Alejandra Garcia-Quintana, Tolulope Titiloye, Suchitra Nelson, Shreela V Sharma

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in Journal of public health dentistry, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Trial
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Jose-Miguel YamalDepartment of Biostatistics and Data Science, Coordinating Center for Clinical Trials, The University of Texas Health Science Center at Houston (UTHealth Houston) School of Public Health, Houston, Texas, USA.ORCID https://orcid.org/0000-0003-2505-0090
Dania MoflehDepartment of Epidemiology, Center for Health Equity, The University of Texas Health Science Center at Houston (UTHealth Houston) School of Public Health, Houston, Texas, USA.
Ru-Jye ChuangDepartment of Health Promotion & Behavioral Sciences, Center for Health Equity, The University of Texas Health Science Center at Houston (UTHealth Houston) School of Public Health, Houston, Texas, USA.
Mengxi WangDepartment of Biostatistics and Data Science, Coordinating Center for Clinical Trials, The University of Texas Health Science Center at Houston (UTHealth Houston) School of Public Health, Houston, Texas, USA.
Kila JohnsonCommunity Health and Wellness Division, Dental Health and Prevention, Harris County Public Health, Houston, Texas, USA.
Alejandra Garcia-QuintanaDepartment of Epidemiology, Center for Health Equity, The University of Texas Health Science Center at Houston (UTHealth Houston) School of Public Health, Houston, Texas, USA.
Tolulope TitiloyeDepartment of Epidemiology, Center for Health Equity, The University of Texas Health Science Center at Houston (UTHealth Houston) School of Public Health, Houston, Texas, USA.
Suchitra NelsonCase Western Reserve University, Department of Community Dentistry, Cleveland, Ohio, USA.ORCID https://orcid.org/0000-0002-1204-7020
Shreela V SharmaDepartment of Epidemiology, Center for Health Equity, The University of Texas Health Science Center at Houston (UTHealth Houston) School of Public Health, Houston, Texas, USA.ORCID https://orcid.org/0000-0002-4668-5020

Funding

CATCH Healthy Smiles: A cluster-RCT of an elementary school oral health interventionUH3DE029213 · NIDCR · UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON · PI SHARMA, SHREELA V · 2021 to 2025
$5.5M
NIDCR NIH HHS 4UH3DE029213-02NIDCR NIH HHS UH3 DE029213
6 · The paper itself

Abstract

objectivesThis paper demonstrates International Caries Detection and Assessment System (ICDAS) training procedures and inter/intra-examiner reliability for lesion severity, activity, and filling criteria in an elementary school setting.

methodsICDAS training was conducted in December 2021 prior to a school-based cluster-randomized controlled trial. A total of 59 children (6-8 years old) in grades 1-2 from one school in Houston, Texas were recruited. Two licensed dentists received a 5-day training from an ICDAS trainer at the participating school. Thirty-eight children were evaluated at least once by each dental trainee, and 18 had repeat examinations. The ICDAS criteria were used to classify dental caries lesion severity (0-6), lesion activity (active/inactive), and filling material (0-9) of all visually available primary and permanent tooth surfaces. Inter and intra-examiner reliability between each dental trainee and the "gold standard" trainer was evaluated using Kappa statistics.

resultsFor lesion severity, the examination indicated an inter-rater weighted Kappa of 0.77 (95% CI 0.71-0.82) and 0.82 (95% CI 0.77-0.87) for each trainee examiner compared to the gold standard examiner. The Kappas increased slightly from the first to second examinations (lesion-weighted Kappa: 0.76 to 0.84 and 0.82 to 0.84). The intra-rater reliability indicated excellent reliability for lesion and filling (0.83 to 0.94) and moderate for activity (0.58).

conclusionsICDAS training/calibration were essential to ensure accuracy and reliability of dental caries measurements. The study demonstrated that ICDAS training of dentists with no prior criteria experience is feasible in a community setting and can lead to high reliability and repeatability.

Indexed as

Dental CariesCalibrationChildFemaleHumansMaleObserver VariationReproducibility of ResultsTexascariescommunity‐based studydental examinersICDASreliability

Identifiers

PMID39647994
PMCPMC12227147

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.