THE INFLUENCE OF AUDIT ON THE DIAGNOSIS OF OCCLUSAL CARIES

Audit is widely used to improve the quality of care in both medicine a nd dentistry but has not always been subject to systematic evaluation. The aim of this study was to assess the effect of an audit exercise o n the diagnosis of occlusal caries. Using combined visual and radiogra phic methods, 11 dentists assessed 60 extracted molars for occlusal ca ries on two occasions. An audit exercise, in the form of a meeting, wa s carried out in the intervening period. Inter- and intra-examiner rep roducibility were estimated for each of the two examinations. Validati on was through a gold standard set up by sectioning the teeth. Wide di agnostic disparity was seen at both examinations, all inter- and intra -examiner kappa values were below 0.73. Intra-examiner kappa values in creased significantly on the second occasion. Mean sensitivity and spe cificity were 0.65 and 0.74, respectively, at the first examination an d 0.65 and 0.72 at the second. No changes were seen that could be attr ibuted directly to the audit exercise but practising the diagnostic te st appeared to be beneficial to intra-examiner reproducibility of diag nosis.