Application of the Orthodontics Clinical Reference Guide  (GRCO) by calibrated dentists

To assess the agreement rate of the Primary Health Care (PHC) dentists in applying of the "Orthodontics Clinical Reference Guide (GRCO)"  at orthodontic referrals after a calibration training course complemented by a User Guide. 

Method:

In an experimental study, three general dentists applied the GRCO, calibrated with a support course and a guidance manual, and  assessed 50 dental models from patients with different malocclusions, ages and dentition. They recorded their decision to refer or not, each patient to orthodontics, contrasting it with the Gold Standard set by a Cohen’s Kappa calibrated orthodontist, who set the Gold Standard in the project which created the guide

Result:

Concordance results obtained by Cohen’s Kappa: observers 1, 2 and 3 was 0.96, 0.79 and 0.96 respectively. Sensitivity obtained for observers 1, 2 and 3 was 96%, 79% and 96% respectively. Specificity was of a 100% for all the dentists.

Conclusion:

A GRCO training course together with the support of a User Manual, achieve a high level of standardization in the opinion of the Dentists. This confirms the results of the research project which created the guide, about the recommendation of the use of the GRCO by PHC dentists to help optimizing the resources in the Public Health Services.