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An Analytical Study on an Orthodontic Index: Index of Complexity, Outcome and Need (ICON).

Torkan S, Pakshir HR, Fattahi HR, Oshagh M, Momeni Danaei S, Salehi P, Hedayati Z - J Dent (Shiraz) (2015)

Bottom Line: A new cut-off point was adjusted at 35 in lieu of 43 as the suggested cut-off point.As for complexity of treatment, the index is not validated for our society.It seems that ICON is a well-suited substitute for the IOTN index.

View Article: PubMed Central - PubMed

Affiliation: Shiraz Orthodontic Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

ABSTRACT

Statement of the problem: The validity of the Index of Complexity, Outcome and Need (ICON) which is an orthodontic index developed and introduced in 2000 should be studied in different ethnic groups.

Purpose: The aim of this study was to perform an analysis on the ICON and to verify whether this index is valid for assessing both the need and complexity of orthodontic treatment in Iran.

Materials and method: Five orthodontists were asked to score pre-treatment diagnostic records of 100 patients with a uniform distribution of different types of malocclusions determined by Dental Health Component of the Index of Treatment Need. A calibrated examiner also assessed the need for orthodontic treatment and complexity of the cases based on the ICON index as well as the Index of Orthodontic Treatment Need (IOTN). 10 days later, 25% of the cases were re-scored by the panel of experts and the calibrated orthodontist.

Results: The weighted kappa revealed the inter-examiner reliability of the experts to be 0.63 and 0.51 for the need and complexity components, respectively. ROC curve was used to assess the validity of the index. A new cut-off point was adjusted at 35 in lieu of 43 as the suggested cut-off point. This cut-off point showed the highest level of sensitivity and specificity in our society for orthodontic treatment need (0.77 and 0.78, respectively), but it failed to define definite ranges for the complexity of treatment.

Conclusion: ICON is a valid index in assessing the need for treatment in Iran when the cut-off point is adjusted to 35. As for complexity of treatment, the index is not validated for our society. It seems that ICON is a well-suited substitute for the IOTN index.

No MeSH data available.


Related in: MedlinePlus

Sensitivity and specificity at different cut-off points for the panel of experts
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Figure 1: Sensitivity and specificity at different cut-off points for the panel of experts

Mentions: When the intra-examiner reliability of the calibrated orthodontist was assessed, the kappa coefficient showed almost perfect agreement (kappa= 0.82, p< 0.00). After dichotomizing the results as “no treatment need” and “treatment required”, the intra-examiner reliability for the calibrated examiner was still “almost perfect” (kappa=0.89, p< 0.00).In order to evaluate the validity of ICON index in assessing the need for treatment, the sensitivity and specificity of ICON index at different cuff-off points was evaluated using the ROC curve. It was shown that the best cut-off point in our community for definite treatment need was 35.5 in lieu of 43 (Figure 1 and Table 3). A new cut-off point was adjusted at 35 in lieu of 43 as the suggested cut-off point. It showed the highest level of sensitivity and specificity in our society (0.77 and 0.78, respectively), but it failed to define definite ranges for the complexity of treatment.


An Analytical Study on an Orthodontic Index: Index of Complexity, Outcome and Need (ICON).

Torkan S, Pakshir HR, Fattahi HR, Oshagh M, Momeni Danaei S, Salehi P, Hedayati Z - J Dent (Shiraz) (2015)

Sensitivity and specificity at different cut-off points for the panel of experts
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4554305&req=5

Figure 1: Sensitivity and specificity at different cut-off points for the panel of experts
Mentions: When the intra-examiner reliability of the calibrated orthodontist was assessed, the kappa coefficient showed almost perfect agreement (kappa= 0.82, p< 0.00). After dichotomizing the results as “no treatment need” and “treatment required”, the intra-examiner reliability for the calibrated examiner was still “almost perfect” (kappa=0.89, p< 0.00).In order to evaluate the validity of ICON index in assessing the need for treatment, the sensitivity and specificity of ICON index at different cuff-off points was evaluated using the ROC curve. It was shown that the best cut-off point in our community for definite treatment need was 35.5 in lieu of 43 (Figure 1 and Table 3). A new cut-off point was adjusted at 35 in lieu of 43 as the suggested cut-off point. It showed the highest level of sensitivity and specificity in our society (0.77 and 0.78, respectively), but it failed to define definite ranges for the complexity of treatment.

Bottom Line: A new cut-off point was adjusted at 35 in lieu of 43 as the suggested cut-off point.As for complexity of treatment, the index is not validated for our society.It seems that ICON is a well-suited substitute for the IOTN index.

View Article: PubMed Central - PubMed

Affiliation: Shiraz Orthodontic Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

ABSTRACT

Statement of the problem: The validity of the Index of Complexity, Outcome and Need (ICON) which is an orthodontic index developed and introduced in 2000 should be studied in different ethnic groups.

Purpose: The aim of this study was to perform an analysis on the ICON and to verify whether this index is valid for assessing both the need and complexity of orthodontic treatment in Iran.

Materials and method: Five orthodontists were asked to score pre-treatment diagnostic records of 100 patients with a uniform distribution of different types of malocclusions determined by Dental Health Component of the Index of Treatment Need. A calibrated examiner also assessed the need for orthodontic treatment and complexity of the cases based on the ICON index as well as the Index of Orthodontic Treatment Need (IOTN). 10 days later, 25% of the cases were re-scored by the panel of experts and the calibrated orthodontist.

Results: The weighted kappa revealed the inter-examiner reliability of the experts to be 0.63 and 0.51 for the need and complexity components, respectively. ROC curve was used to assess the validity of the index. A new cut-off point was adjusted at 35 in lieu of 43 as the suggested cut-off point. This cut-off point showed the highest level of sensitivity and specificity in our society for orthodontic treatment need (0.77 and 0.78, respectively), but it failed to define definite ranges for the complexity of treatment.

Conclusion: ICON is a valid index in assessing the need for treatment in Iran when the cut-off point is adjusted to 35. As for complexity of treatment, the index is not validated for our society. It seems that ICON is a well-suited substitute for the IOTN index.

No MeSH data available.


Related in: MedlinePlus