An evaluation by teachers of a decision aid for viewing bitewing radiographs

To evaluate a new decision aid to improve restorative treatment decision making for proximal caries from bitewing radiographs.

Dental teachers involved in patient treatment and clinical caries diagnosis (n = 31) viewed a computerized decision aid. Whilst using the aid, measures of the teachers' diagnostic and treatment accuracy, and also their decision-making knowledge and values were recorded. After completing the aid, they evaluated its performance on ten aspects using visual analogue scales. We carried out two linear regression analyses, using "Overall usefulness" of the aid as the dependent variable. The independent variables were (1) nine decision-making variables and (2) the nine other aspects of aid performance.

The teachers gave the program a mean overall usefulness score of 70% (median 73%, standard deviation (SD) 15%). Information presentation scored lowest (mean 58.9 %, median 64.5%, SD 19%) and aesthetic appearance of the aid scored highest (mean 77.4%, median 80.5%, SD 11.5%). The teachers' diagnostic and treatment decision-making acumen was not related to the score for overall usefulness (P > 0.14). Dentists with a lower subjective estimate of the probability of disease or a higher subjective estimate of 10-year restoration survival valued the aid more highly (P < or = 0.001).

The basic decision-making variables from which the aid provides individual feedback and advice may need additional improvement in presentation. Despite shortcomings and irrespective of the users' diagnostic ability, the aid was valued as generally useful.