ASSESSMENT OF DIAGNOSTIC-ACCURACY IN CARIES DETECTION - AN ANALYSIS OF 2 METHODS

The quality of a diagnostic tool for caries detection is usually evalu ated by quantification of observer performance using sensitivity and s pecificity values calculated from data obtained from ordinal caries de pth rating scales. The application of Receiver Operating Characteristi c (ROC) analysis has been restricted to the use of confidence rating s cales. The aim of this investigation was to study the appropriateness of ROC analysis using caries depth ratings by comparing sensitivity an d specificity values to parameters of diagnostic performance obtained by ROC analysis. In two recent reports, sensitivity and specificity va lues were utilized to express diagnostic accuracy of observer performa nce from specified caries diagnostic systems. The raw data from these investigations were subjected to ROC analysis in the current study. Th e results illustrated that ROC analysis, producing estimates of sensit ivities for all specificities, yielded more comprehensive measures of diagnostic performance than single values for sensitivity and specific ity. In particular, the area under the ROC curve constituted a clearly interpretable parameter representing the quality of diagnostic perfor mance.