Upload
devin-hughes
View
219
Download
1
Tags:
Embed Size (px)
Citation preview
Introdução à MedicinaIntrodução à Medicina
Validity of remote dental Validity of remote dental diagnosis of children by diagnosis of children by
medical studentsmedical students
Introdução à MedicinaIntrodução à Medicina
IntroductionIntroduction
Portuguese children oral health care is deficientPortuguese children oral health care is deficient
Dental Caries Prevalence
Have dental caries
Have no dental caries
Fist dentist consultation
After 6 years old
Until 6 years old
49% have dental caries (by Direcção-Geral de Saúde)*49% have dental caries (by Direcção-Geral de Saúde)*
56% never went to the dentist (by Sociedade Portuguesa de Estomatologia 56% never went to the dentist (by Sociedade Portuguesa de Estomatologia e Medicina Dentária)*e Medicina Dentária)*
*References in last References in last slideslide
Introdução à MedicinaIntrodução à Medicina
IntroductionIntroduction
Telemedicine using Telemedicine using low-cost and widespread low-cost and widespread technologytechnology
Our study is based on Dr Rui Amável’s studyOur study is based on Dr Rui Amável’s study
What is the reproducibility and What is the reproducibility and validity of remote diagnosis by first validity of remote diagnosis by first
year medical students using year medical students using photographs as a method of photographs as a method of screening children's dental screening children's dental
problems?problems?
Introdução à MedicinaIntrodução à Medicina
Participants and MethodsParticipants and Methods
Introdução à MedicinaIntrodução à Medicina
Study designStudy design
Target-population - first year medical students of Target-population - first year medical students of Universidade do PortoUniversidade do Porto
ObservationalObservational
TransversalTransversal
AnalyticalAnalytical
Unit of study – photographsUnit of study – photographs
Diagnosis method evaluation studyDiagnosis method evaluation study
Introdução à MedicinaIntrodução à Medicina
Data collectionData collection
PhotographsPhotographs
Sixty six childrenSixty six children
Three photos for each childThree photos for each child
Dr Rui Amável’s criteriaDr Rui Amável’s criteria
Introdução à MedicinaIntrodução à Medicina
Data collectionData collection
QuestionnaireQuestionnaire filling filling
Recognition of necessity of specialist’s attendanceRecognition of necessity of specialist’s attendance
Introdução à MedicinaIntrodução à Medicina
Statistical AnalysisStatistical Analysis Divide the photos for three disjoint sets (22 Divide the photos for three disjoint sets (22
children for each):children for each): I, II and III I, II and III
Two groups of 4 students (A and B) and one of 5 Two groups of 4 students (A and B) and one of 5 (C). (13 class members)(C). (13 class members)
Comparison of the two Comparison of the two stagesstages
Intra observer agreementIntra observer agreement
Inter observer agreementInter observer agreement
Correction rateCorrection rate
SensibilitySensibility
SpecificitySpecificity
Comparison with specialistsComparison with specialists
Stage 1Stage 1Group A: Set IGroup A: Set I
Group B: Set IIGroup B: Set II
Group C: Set IIIGroup C: Set III
Stage 2Stage 2Group A: Set IIGroup A: Set II
Group B: Set IIIGroup B: Set III
Group C: Set IGroup C: Set I
Introdução à MedicinaIntrodução à Medicina
FlowchartFlowchartBeginning
Read 1st analysis of the first stage
Read 2nd analysis of the first stage
Intra-observer agreement rate
Inter-observer agreement rate
Read Gold Standard
Introdução à MedicinaIntrodução à Medicina
FlowchartFlowchart
End
Compare 1st and 2nd analysis with Gold Standard
Specificity and Sensibility
Record results and conclusions
Explore errors
Read 1st and 2nd analysis of the second stage
Introdução à MedicinaIntrodução à Medicina
Gantt chartGantt chart
1.1. Formation with Dr Rui Amável Formation with Dr Rui Amável
2.2. First analysis of the first stage First analysis of the first stage
3.3. Second analysis of the first stage Second analysis of the first stage
4.4. Comparison of the results Comparison of the results
5.5. First analysis of the second stage First analysis of the second stage
6.6. Second analysis of the second stage Second analysis of the second stage
7.7. Comparison of the results Comparison of the results
Introdução à MedicinaIntrodução à Medicina
Expected ResultsExpected Results
First year medical students are able to First year medical students are able to recognize the necessity of specialist’s recognize the necessity of specialist’s
attendance only by looking at children mouths’ attendance only by looking at children mouths’ photos…photos…
Introdução à MedicinaIntrodução à Medicina
ReferencesReferencesLeao JC, Porter SR. Telediagnosis of oral disease. Department of Oral Medicine, Eastman Leao JC, Porter SR. Telediagnosis of oral disease. Department of Oral Medicine, Eastman Dental Institute for Oral Health Care Sciences, University of London, England. Dental Institute for Oral Health Care Sciences, University of London, England. PMID: PMID: 10863389 Pubmed 10863389 Pubmed Almeida CM, Petersen PE, André SJ, Toscano A. Changing oral health status of 6- and 12-Almeida CM, Petersen PE, André SJ, Toscano A. Changing oral health status of 6- and 12-year-old schoolchildren in Portugal. Department for Community Dental Health, Faculty year-old schoolchildren in Portugal. Department for Community Dental Health, Faculty of Dental Medicine, University of Lisbon, Portugal. PMID: 14696739 PubMed of Dental Medicine, University of Lisbon, Portugal. PMID: 14696739 PubMed Rui Amável, José Bulhosa, Ricardo Cruz-Correia. Rui Amável, José Bulhosa, Ricardo Cruz-Correia. Potencial of teledentistry in the early Potencial of teledentistry in the early diagnosis of caries. diagnosis of caries. Proceedings of the 1st Medical Informatics Symposium. 2008 Proceedings of the 1st Medical Informatics Symposium. 2008 Programa "Mês da Saúde Oral" da Colgate Portugal e SPEMD - Relatório Estatístico de Programa "Mês da Saúde Oral" da Colgate Portugal e SPEMD - Relatório Estatístico de Set.2006. Set.2006. (2006). Retrieved Fev 2008, from (2006). Retrieved Fev 2008, from http://http://www.spemd.pt/indexRastreios.htmlwww.spemd.pt/indexRastreios.html Wheeler, T. (1999). Smile for the camera: telemedicine comes to your local dentist's Wheeler, T. (1999). Smile for the camera: telemedicine comes to your local dentist's office. office. Telemed Today, 14(5), 42. Telemed Today, 14(5), 42. Ministério da Saúde. (2008). Estudo Nacional de Prevalência das Doenças Orais. Ministério da Saúde. (2008). Estudo Nacional de Prevalência das Doenças Orais. Lisboa. Lisboa. Shortliffe, E., & Cimino, J. (2006). Biomedical Informatics – Computer Applications in Shortliffe, E., & Cimino, J. (2006). Biomedical Informatics – Computer Applications in Health Care and Biomedicine (3rd ed.): Springer Health Care and Biomedicine (3rd ed.): Springer Sociedade Portuguesa de Estomatologia e Medicina Dentária. Sociedade Portuguesa de Estomatologia e Medicina Dentária. (2007). Newsletter nº6: (2007). Newsletter nº6: Colgate Palmolive Colgate Palmolive AMG, C. (1994). AMG, C. (1994). Contribuição para o estudo da prevalência e da gravidade da cárie Contribuição para o estudo da prevalência e da gravidade da cárie dentária nos dentes temporários das crianças portuguesas. Universidade do Porto, Porto dentária nos dentes temporários das crianças portuguesas. Universidade do Porto, Porto Bashshur, R., Sanders, J., & Shannon, G. (1997). Bashshur, R., Sanders, J., & Shannon, G. (1997). Telemedicine: Theory and practice. Telemedicine: Theory and practice. Springfield, IL. Springfield, IL.