Visual and radiographic caries detection: a tailored meta-analysis for two different settings, Egypt and Germany

Falk Schwendicke, Karim Elhennawy, Osama El Shahawy, Reham Maher, Thais Gimenez, Fausto Mendes, Brian H. Willis

Research output: Contribution to journalArticlepeer-review

108 Downloads (Pure)


Background: Diagnostic meta-analyses on caries detection methods should assist practitioners in their daily practice. However, conventional meta-analysis estimates may be inapplicable due to differences in test conduct, applied thresholds and assessed population between settings. Our aim was to demonstrate the impact of tailored meta-analysis of visual and radiographic caries detection to different settings using setting-specific routine data.

Methods: Published systematic reviews and meta-analyses on the accuracy of visual and radiographic caries detection were used. In two settings (a private practice in Germany and a public health clinic in Egypt), routine data of a total of 100 (n = 50/practice) consecutive 12–14 year-olds were collected. Test-positive rates of visual and radiographic detection for initial and advanced carious lesions on occlusal or proximal surfaces of molars were used to tailor meta-analyses. If prevalence data were available, these were also used for tailoring.

Results: From the original reviews, 210 and 100 heterogeneous studies on visual and radiographic caries detection were included in our meta-analyses. For radiographic detection, sensitivity and specificity estimates derived from conventional and tailored meta-analysis were similar. For visual detection of advanced occlusal carious lesions, the conventional meta-analysis yielded a sensitivity and specificity (95% CI) of 64.6% (57–71) and 90.9% (88–93), whereas the tailored estimates for Egypt were 75.1% (70–81) and 84.9% (82–89), respectively, and 43.7% (37–51) and 96.5% (95–97) for Germany, respectively.

Conclusion: Conventional test accuracy meta-analyses may yield aggregate estimates which are inapplicable to specific settings. Routine data may be used to produce a meta-analysis estimate which is tailored to the setting and thereby improving its applicability.
Original languageEnglish
Article number105
Number of pages9
JournalBMC oral health
Publication statusPublished - 8 Jun 2018


  • caries detection
  • decision making
  • diagnostic accuracy studies
  • evidence-based dentistry
  • medical informatics


Dive into the research topics of 'Visual and radiographic caries detection: a tailored meta-analysis for two different settings, Egypt and Germany'. Together they form a unique fingerprint.

Cite this