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radiologia:introduccion_a_la_radiologia_dental_y_maxilofacial

# Introducción

## Why radiographs in dentistry?

Radiographs are essential to dentists for:

  • Diagnosis
  • Treatment planning
  • Monitoring treatment or lesion development

However, an integral part of radiography is exposure of patients and, potentially, clinical staff to X-rays. No exposure to X-rays can be considered completely free of risk, so the use of radiation by dentists is accompanied by a responsibility to ensure appropriate protection.

 doi:10.1016/S0140-6736(05)66422-7

## Conceptos básicos

  • Diagnostico
  • Anormal : gaussiana, percentil, cultural, riesgo, diagnostico, terapeutico
  • Detección
  • Gold standard
  • Validez
  • Reproducibilidad
  • Sensibilidad
  • Especificidad
  • Valores predictivos
  • Umbral de diagnóstico
  • Umbral de tratamiento
  • Razones de verosimilitud (Likelihood ratios)

## Nemotecnia SENS elevada con resultado NEG descarta SnOUT

SPEC elevada con resultado POS confirma: SpPIN

## Niveles de evidencia diagnóstica de Fryback y Thornbury

  1. Nivel 1: eficacia técnica → se ve algo?
  2. Nivel 2: eficacia diagnóstica → permite diagnosticar?
  3. Nivel 3: pensamiento diagnóstico → ayuda?
  4. Nivel 4: eficacia terapéutica → se disminuyó el n de procedimientos gracias a esto? cambió la decisión de tratamiento?
  5. Nivel 5: resultado orientado al paciente → disminuye mortalidad, morbilidad o mejora QL?
  6. Nivel 6: eficacia societal → costo-beneficio para la sociedad, costo-efectividad para la sociedad

## Radiología basada en la evidencia Diagnostic accuracy efficacy (20) was defined as:

  1. Observer performance expressed as overall agreement, Kappa Index or correlation coefficients;
  2. Diagnostic accuracy as percentage of correct XXX;
  3. Diagnostic accuracy as percentage of correct XXX;
  4. Sensitivity, specificity or predictive values;

Diagnostic thinking efficacy (20) was defined as:

  1. Percentage of cases in a series in which DIAGNOSTIC TOOL was judged ‘helpful’ to guide the TREATMENT;
  2. Difference in clinicians’ subjectively estimated diagnosis probabilities pre- to post-DIAGNOSTIC TOOL;

Therapeutic efficacy (20) was defined as:

  1. Percentage of times DIAGNOSTIC TOOL judged helpful in planning management of the patient in a case series;
  2. Percentage of times therapy-planned DIAGNOSTIC TOOL changed after the DIAGNOSTIC TOOL information was obtained;
  3. Percentage of times clinicians’ prospectively stated therapeutic choices changed after DIAGNOSTIC TOOL information.
radiologia/introduccion_a_la_radiologia_dental_y_maxilofacial.txt · Última modificación: 2018/03/16 05:00 (editor externo)