The influence of diagnostic information format on orthodontic treatment planning : a feasibility study
Aims: The aims of this feasibility study were to assess intra-observer reproducibility of treatment plans when developed from clinical examination, hard copy records and digital records. Inter-observer reproducibility of treatment plans was also assessed when using hard copy and digital records. The aim was also to assess subject satisfaction with the conventional consultation system and to identify any differences of opinion between urban and rural subjects in the use of digital records for new patient consultations. Materials and Methods: Twenty-seven subjects attended orthodontic consultations where two of four observers assessed them clinically and developed a treatment plan. Also at this consultation, records were taken enabling the construction of hard copy and digital records. Subjects were also asked to complete a questionnaire regarding their satisfaction with the consultation and perceived benefits of teleorthodontics. Following a one month wash out period all observers were asked to develop treatment plans for every subject using hard copy records, then repeated after a further month using digital records. Results and Conclusions: Cohen’s kappa coefficient was used to show intra-observer reproducibility for clinical vs hard copy, hard copy vs digital and clinical vs digital treatment plans. Observer 1 showed good levels of agreement (?=0.686, 0.692, 0.633). Observer 2 showed good levels of agreement when comparing clinical with hard copy records and hard copy with digital records, but only fair levels of agreement when comparing clinical and digital records (?=0.681, 0.637, 0.362). Observer 3 showed fair agreement when comparing clinical and hard copy records and hard copy with digital records, but poor agreement between clinical and digital records(?=0.317, 0.326, 0.153). Observer 4 showed moderate agreement for each comparison of diagnostic record format (?=0.543, 0.498, 0.592). Inter-observer agreement using hard copy records was moderate and using digital records was fair (?=0.490, 0.377) Two thirds of subjects were very satisfied with the conventional consultation. No subjects were unsatisfied. Two subjects were from remote and rural communities, both felt that teleorthodontics would make it easier for them to receive an orthodontic consultation, save them time and money and one thought it could save them inconvenience.
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