Statistical methods for comparing dental diagnostic procedures

In dental diagnosis, there are typically two or more clinical diagnostic procedures which may be used either independently or jointly to reach a conclusion regarding the presence of a particular disease in a patient. To determine which of these diagnostic procedures are more accurate, statistical methods may be applied to research data in which the true health status as well as the diagnosis provided by each clinical procedure are available on each observation. Results arising from this type of analysis can be of great interest to clinicians when the diagnostic procedures themselves are costly, painful, or even potentially harmful to the patient. Considered here is the special situation encountered in dental research in which each patient can have multiple concurrent cases of a certain disease such as caries, for then the statistical evaluation of diagnostic procedures is even further complicated. This report describes several statistical approaches for comparing the efficacy of diagnostic tests and illustrates their application on data from a study of diagnostic radiographs for dental caries.