Abstract
Background: A new periodontitis classification was recently introduced involving multidimensional staging and grading. The aim of the study was to assess if individuals well-trained in periodontics consistently used the new classification for patients with severe periodontitis. The secondary goal was to identify “gray zones” related to classifications. Methods: Participants (raters) individually classified 10 pre-selected severe periodontitis cases using the 2017 World Workshop classification. An internet case-based study was conducted after inviting members from American Academy of Periodontology and European Federation of Periodontology. Gold-standard diagnoses were determined by five experts who developed the new periodontitis classification. Inter-reliability agreement among raters was assessed using Fleiss Kappa index with the jackknife method for linearly weighted kappa calculations. McNemar test was used to determine symmetry between raters and gold-standard panel. Results: A total of 103 raters participated and classified nine clinical cases. Fleiss Kappa values showed moderate inter-examiner consistency among raters for stage (K value: 0.49; 95% CI, 0.19 to 0.79), grade (K value: 0.50; 95% CI, 0.30 to 0.70) and extent (K value: 0.51; 95% CI, 0.23 to 0.77). When analyzed as composite (stage, grade, extent) a moderate inter-reliability was present among raters, k = 0.479 (K value: 0.47; 95% CI, 0.442 to 0.515). Agreement between raters and gold-standard panel was staging 76.6%; grading 82%; and extent 84.8%. In six of nine cases 77% to 99% of raters consistently agreed with gold-standard panel, and the other three cases had gray zone factors that reduced rater consistency. Conclusions: Clinicians trained in the 2017 World Workshop periodontitis classification demonstrated moderate concordance in classifying nine severe periodontitis cases, and in six of nine cases raters consistently agreed with the gold-standard panel.
| Original language | English |
|---|---|
| Pages (from-to) | 1675-1686 |
| Number of pages | 12 |
| Journal | Journal of Periodontology |
| Volume | 92 |
| Issue number | 12 |
| DOIs | |
| Publication status | Published - Dec 2021 |
Bibliographical note
Publisher Copyright:© 2021 American Academy of Periodontology
Funding
The authors thank all the raters (see Supplementary Table S1 ) for their commitment and essential role in completing the survey, and Adam Barragato (University of Michigan) for helping to construct the survey. Furthermore, the authors thank Drs. Giorgio Pagni (University of Milan), Erin Shan‐Huey Yu (ESY, University of Michigan), Giacomo Gualini (University of Turin), and Marco Clementini (San Raffaele University) for providing some challenging clinical cases. Finally, the authors want to thank Juan Luis Gomez (stHalley Statistics Barcelona) for analysis of the data. This article was supported in part by the University of Michigan Periodontal Graduate Student Research Fund. Competing interests: The authors report no conflicts of interest related to this study. The authors thank all the raters (see Supplementary Table S1) for their commitment and essential role in completing the survey, and Adam Barragato (University of Michigan) for helping to construct the survey. Furthermore, the authors thank Drs. Giorgio Pagni (University of Milan), Erin Shan-Huey Yu (ESY, University of Michigan), Giacomo Gualini (University of Turin), and Marco Clementini (San Raffaele University) for providing some challenging clinical cases. Finally, the authors want to thank Juan Luis Gomez (stHalley Statistics Barcelona) for analysis of the data. This article was supported in part by the University of Michigan Periodontal Graduate Student Research Fund. Competing interests: The authors report no conflicts of interest related to this study.
ASJC Scopus Subject Areas
- Periodontics