VARIATIONS IN RESTORATIVE TREATMENT DECISIONS - AN INTERNATIONAL COMPARISON

Variations between dentists in treatment thresholds and diagnostic dec isions based on radiographs have not been fully explained, Since varia tions have been shown to exist between as well as within countries, it is possible that the structure of incentives inherent in different he alth care systems, and cultural influences on health and health care m ay play a part. This paper compares the results of a study undertaken in Scotland with a replication study undertaken in Canada concerning d entists' restorative thresholds and treatment decisions based on radio graphic evidence. The Canadian dentists operated with greater sensitiv ity but lower specificity than their Scottish counterparts, although R OC analysis indicated similar overall abilities to detect carious lesi ons. The dentists' action thresholds also differed. However, methodolo gical issues mean that the data from the study need to be interpreted with caution.