Validity assessment and determination of the cutoff value for the Index of Complexity, Outcome and Need among 12–13 year-olds in Southern Chinese

Abstract

Analysis of a popular orthodontics assessment tool shows that southern China requires a lower cutoff point than other regions. Using orthodontic data collected from 12–13-year-old students in southern China, Wen-li Lai and co-workers at Sichuan University, China, validated the Index of Complexity, Outcome and Need (ICON) — a computer program used to calculate the perceived severity of malocclusions (misaligned teeth) on a points scale and suggest a point at which treatment is necessary. The researchers compared the scores generated by ICON for the 335 students with individual scores given by 25 professional Chinese orthodontists. Lai and co-workers found that the current cutoff point of ICON used internationally is too high for this region, so they propose a lower cutoff point that is more in-line with the orthodontists' expert opinions.

Keywords

Index of Complexity, Outcome, and Need / occlusal index / treatment need

References

[1] Louwerse TJ, Aartman IH, Kramer GJ. The reliability and validity of the Index of Complexity, Outcome and Need for determining treatment need in Dutch orthodontic practice. Eur J Orthod, 2006, 28(1): 58-64.

[2] Brook PH, Shaw WC. The development of an index of orthodontic treatment priority. Eur J Orthod, 1989, 11(3): 309-320.

[3] Draker HL. Handicapping labio-lingual deviations: a proposed index for public health purposes. Am J Orthod, 1960, 46(4): 295-305.

[4] Cons NC, Jenny J, Kohout FJ . DAI: The Dental Aesthetic Index. Iowa City: University of Iowa, 1986.

[5] Richmond S, Shaw WC, O'Brien KD. The development of the PAR Index (Peer Assessment Rating): reliability and validity. Eur J Orthod, 1992, 14(2): 125-139.

[6] Daniels C, Richmond S. The development of the index of complexity, outcome and need (ICON). J Orthod, 2000, 27(2): 149-162.

[7] Borzabadi-Farahani A, Eslamipour F. The relationship between the ICON index and the dental and aesthetic components of the IOTN index. World J Orthod, 2010, 11(1): 43-48.

[8] Borzabadi-Farahani A, Eslamipour F . Comparison between the index of complexity outcome and need and the index of orthodontic treatment need. Proceeding of the 86th Congress of the European Orthodontic Society; 15–19 June 2010. Portorož, Slovenia. London: European Orthodontic Society, 2010.

[9] Younis JW, Vig KW, Rinchuse DJ. A validation study of three indexes of orthodontic treatment need in the United States. Community Dent Oral Epidemiol, 1997, 25(5): 358-362.

[10] Beglin FM, Firestone AR, Vig KW. A comparison of the reliability and validity of 3 occlusal indexes of orthodontic treatment need. Am J Orthod Dentofacial Orthop, 2001, 120(3): 240-246.

[11] Richmond S . Evaluating Effective Orthodontic Care. Cardiff: First Numeric Ltd, 2005.

[12] Ngom PI, Diagne F, Dieye F. Orthodontic treatment need and demand in Senegalese school children aged 12–13 years. An appraisal using IOTN and ICON. Angle Orthod, 2007, 77(2): 323-330.

[13] Firestone AR, Beck FM, Beglin FM. Validity of the Index of Complexity, Outcome, and Need (ICON) in determining orthodontic treatment need. Angle Orthod, 2002, 72(1): 15-20.

[14] Ngom PI, Diagne F, Aïdara-Tamba AW. Relationship between orthodontic anomalies and masticatory function in adult subjects. Am J Orthod Dentofacial Orthop, 2007, 131(2): 216-222.

[15] Royston P. Approximating the Shapiro–Wilk W-test for non-normality. Stat Comput, 1991, 2(3): 117-119.

[16] Lam FC, Longnecker MT. A modified Wilcoxon rank sum test for paired data. Biometrika, 1983, 70(2): 510-513.

[17] Kerosuo H, Kerosuo E, Niemi M. The need for treatment and satisfaction with dental appearance among young Finnish adults with and without a history of orthodontic treatment. J Orofac Orthop, 2000, 61(5): 330-340.

[18] Metz CE. Basic principles of ROC analysis. Sem Nucl Med, 1978, 8(4): 283-298.

[19] Beck JR, Shultz EK. The use of receiver operating characteristic (ROC) curves in test performance evaluation. Arch Pathol Lab Med, 1986, 110(1): 13-20.

[20] Swets JA, Getty DJ, Pickett RM. Enhancing and evaluating diagnostic accuracy. Med Decis Making, 1991, 11(1): 9-17.

[21] Hanley JA, McNeil BJ. The meaning and use of the area under a receiver operating characteristic (ROC) curve. Radiology, 1982, 143(1): 29-36.

[22] Altman DG . Practical Statistics for Medical Research. London: Chapman & Hall, 1991.

[23] Koochek AR, Yeh MS, Rolfe B. The relationship between Index of Complexity, Outcome and Need, and patients' perceptions of malocclusion: a study in general dental practice. Br Dent J, 2001, 191(6): 325-329.

[24] Cooke M, Gerbert B, Gansky S. Assessment of the validity of HLD (CalMod) in identifying orthodontic treatment need. Community Dent Oral Epidemiol, 2010, 38(1): 50-57.

[25] Fox NA, Daniels C, Gilgrass T. A comparison of the index of complexity outcome and need (ICON) with the peer assessment rating (PAR) and the index of orthodontic treatment need (IOTN). Br Dent J, 2002, 193(4): 225-230.

[26] Weerakone S, Dhopatkar A. Clinical outcome monitoring program (COMP): a new application for use in orthodontic audits and research. Am J Orthod Dentofacial Orthop, 2003, 123(5): 503-510; discussion 510–511.

[27] Savastano NJ, Firestone AR, Beck FM. Validation of the complexity and treatment outcome components of the index of complexity, outcome, and need (ICON). Am J Orthod Dentofacial Orthop, 2003, 124(3): 244-248.

[28] Mirabelli JT, Huang GJ, Siu CH. The effectiveness of phase I orthodontic treatment in a Medicaid population. Am J Orthod Dentofacial Orthop, 2005, 127(5): 592-598.

[29] Onyeaso CO, Begole EA. Relationship between index of complexity, outcome and need, dental aesthetic index, peer assessment rating index, and American Board of Orthodontics objective grading system. Am J Orthod Dentofacial Orthop, 2007, 131(2): 248-252.

[30] Templeton KM, Powell R, Moore MB. Are the Peer Assessment Rating Index and the Index of Treatment Complexity, Outcome, and Need suitable measures for orthognathic outcomes?. Eur J Orthod, 2006, 28(5): 462-466.

[31] Onyeaso CO. Orthodontic treatment complexity and need in a group of Nigerian patients: the relationship between the Dental Aesthetic Index (DAI) and the Index of Complexity, Outcome, and Need (ICON). J Contemp Dent Pract, 2007, 8(3): 37-44.

[32] Brown R, Richmond S. An update on the analysis of agreement for orthodontic indices. Eur J Orthod, 2005, 27(3): 286-291.

[33] Kerosuo H, Al Enezi S, Kerosuo E. Association between normative and self-perceived orthodontic treatment need among Arab high school students. Am J Orthod Dentofacial Orthop, 2004, 125(3): 373-378.

[34] Fu M, Zhang D, Wang B. The prevalence of malocclusion in China—an investigation of 25392 children. Chin J Stomat, 2002, 37(5): 371-373.

[35] Ren Y, Boxum C, Sandham A. Patients' perceptions treatment need, and complexity of orthodontic re-treatment. Eur J Orthod, 2009, 31(2): 189-195.

[36] Urtane I, Pugaca J, Liepa A. The severity of malocclusion and need for orthodontic treatment in correspondence with the age. Stomatologija, 2006, 8(2): 35-38.

[37] Zhang J, Qiao M. Cephalometric analysis of the patients with bimaxillary protrusion in South China. Hua Xi Kou Qiang Yi Xue Za Zhi, 2001, 19(1): 32-34. Chinese.

[38] Wheeler TT, McGorray SP, Yurkiewicz L. Orthodontic treatment demand and need in third and fourth grade schoolchildren. Am J Orthod Dentofacial Orthop, 1994, 106(1): 22-33.