Understanding the Influence of Patient Factors on Accuracy and Decision-Making in a Diagnostic Accuracy Study with Multiple Raters—A Case Study from Dentistry

Kirstin Vach (), Nadine Schlueter, Carolina Ganss and Werner Vach
Additional contact information
Kirstin Vach: Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Stefan-Meier-Str. 26, D-79104 Freiburg, Germany
Nadine Schlueter: Department of Conservative Dentistry, Periodontology and Preventive Dentistry, Hannover Medical School, Carl-Neuberg-Str. 1, D-30625 Hannover, Germany
Carolina Ganss: Department for Operative Dentistry, Endodontics, and Pediatric Dentistry, Section Cariology of Ageing, Philipps-University Marburg, Georg-Voigt-Str. 3, D-35039 Marburg, Germany
Werner Vach: Basel Academy for Quality and Research in Medicine, Steinenring 6, CH-4051 Basel, Switzerland

IJERPH, 2023, vol. 20, issue 3, 1-19

Abstract: In diagnostic accuracy studies, the test of interest is typically applied only once in each patient. This paper illustrates some possibilities that arise when diagnoses are carried out by a sufficiently large number of multiple raters. In a dental study, sixty-one examiners were asked to diagnose 49 tooth areas with different grades of tissue loss (minor, moderate, and advanced) to decide whether dentine was exposed (positive status) or not (negative status). The true status was determined by histology (reference). For each tooth, the rate of correct decisions reflecting the difficulty to diagnose this tooth and the positive rate reflecting the perception of the tooth by the raters was computed. Meta-analytical techniques were used to assess the inter-tooth variation and the influence of tooth-specific factors on difficulty or perception, respectively. A huge variation in diagnostic difficulty and perception could be observed. Advanced tissue loss made diagnoses more difficult. The background colour and tissue loss were associated with perception and may hint to cues used by the raters. The use of multiple raters in a diagnostic accuracy study allows detailed investigations which make it possible to obtain further insights into the decision-making process of the raters.

Keywords: diagnostic study; accuracy; multiple raters; meta-analysis; enamel; dentine; diagnostic difficulty; perception (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
References: View complete reference list from CitEc
Citations:

Downloads: (external link)
https://www.mdpi.com/1660-4601/20/3/1781/pdf (application/pdf)
https://www.mdpi.com/1660-4601/20/3/1781/ (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:gam:jijerp:v:20:y:2023:i:3:p:1781-:d:1040122

Access Statistics for this article

IJERPH is currently edited by Ms. Jenna Liu

More articles in IJERPH from MDPI
Bibliographic data for series maintained by MDPI Indexing Manager ().