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(Reference retrieved automatically from Web of Science through information on FAPESP grant and its corresponding number as mentioned in the publication by the authors.)

The Influence of Cognitive Bias on Caries Lesion Detection in Preschool Children

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Moron, Bruna L. P. [1] ; Novaes, Tatiane F. [1, 2] ; Pontes, Laura R. A. [1] ; Gimenez, Thais [1, 3] ; Lara, Juan S. [1, 4] ; Raggio, Daniela P. [1] ; Braga, Mariana M. [1] ; Mendes, Fausto M. [1]
Total Authors: 8
[1] Univ Sao Paulo, Sch Dent, Dept Pediat Dent, Sao Paulo - Brazil
[2] Cruzeiro do Sul Univ, Sch Dent, Sao Paulo - Brazil
[3] Univ Ibirapuera, Sch Dent, Sao Paulo - Brazil
[4] Univ Manchester, Dent Hlth Unit, Manchester, Lancs - England
Total Affiliations: 4
Document type: Journal article
Source: Caries Research; v. 52, n. 5, p. 420-428, 2018.
Web of Science Citations: 1

We aimed to evaluate whether children's caries experience exerts an influence on the performance of visual and radiographic methods in detecting nonevident proximal caries lesions in primary molars. Eighty children (3-6 years old) were selected and classified as having a lower (<= 3 decayed, missing, or filled surfaces; dmf-s) or higher (> 3 dmf-s) caries experience. Two calibrated examiners then assessed 526 proximal surfaces for caries lesions using visual and radiographic methods. As a reference standard, 2 other examiners checked the surfaces after temporary separation. Noncavitated and cavitated lesion thresholds were considered and Poisson multilevel regression analyses were conducted to evaluate the influence of caries experience on the performance of diagnostic strategies. Accuracy parameters stratified by caries experience were also derived. A statistically significant influence of caries experience was observed only for visual inspection, with more false-positive results in children with a higher caries experience at the noncavitated lesion threshold, and more false results at the cavitated threshold. The detection of noncavitated caries lesions in children with a higher caries experience was overestimated (specificity = 0.696), compared to children with a lower caries experience (specificity = 0.918), probably due to confirmation bias. However, the examiners underestimated the detection of cavitated lesions in children with a higher caries experience (sensitivity = 0.143) compared to lower-caries-experience children (sensitivity = 0.222), possibly because of representativeness bias. The radiographic method was not influenced by children's caries experience. In conclusion, children's caries experience influences the performance of visual inspection in detecting proximal caries lesions in primary teeth, evidencing the occurrence of cognitive biases. (C) 2018 S. Karger AG, Basel (AU)

FAPESP's process: 12/24243-7 - Impact of radiographic examination on the diagnosis and treatment decision of caries lesions in primary teeth
Grantee:Fausto Medeiros Mendes
Support type: Regular Research Grants