Table 4.
Score | Score Distribution, % | Caries, % | No Caries, % | Sensitivity, % | Specificity, % | Positive Likelihood Ratio | Negative Likelihood Ratio | Positive Predictive Value, % | Negative Predictive Value, % |
---|---|---|---|---|---|---|---|---|---|
0 | 1 | 9 | 91 | 100 | 0 | 1.0 | 29 | ||
1 | 5 | 6 | 94 | 100 | 1 | 1.0 | 29 | 91 | |
2 | 11 | 10 | 90 | 99 | 7 | 1.1 | 0.18 | 30 | 93 |
3 a | 18 | 13 | 87 | 95 | 21 | 1.2 | 0.24 | 33 | 91 |
4 | 19 | 24 | 76 | 87 | 42 | 1.5 | 0.31 | 38 | 89 |
5 b | 20 | 38 | 62 | 71 | 62 | 1.9 | 0.46 | 43 | 84 |
6 | 17 | 41 | 59 | 45 | 80 | 2.2 | 0.69 | 48 | 78 |
7 | 8 | 54 | 46 | 21 | 94 | 3.4 | 0.84 | 58 | 75 |
8 | 2 | 61 | 39 | 7 | 99 | 5.3 | 0.94 | 68 | 72 |
9 | 1 | 75 | 25 | 3 | 100 | 14.9 | 0.98 | 84 | 72 |
10 | <1 | 100 | 0 | 1 | 100 | 0.99 | 100 | 71 | |
11 | <1 | 100 | 0 | 0 | 100 | 1.00 | 100 | 71 |
Example score chosen to provide high sensitivity and low specificity (e.g., resulting in only 5% false negatives [children who will develop cavitated lesions who would not be treated and/or referred] and about 80% false positives [children who will not develop caries lesions being treated and/or referred]).
Example score chosen to provide both modest sensitivity and specificity (e.g., resulting in approximately 30% false negatives and approximately 40% false positives).
Based on the distribution of both of these scores in the population, both would decrease or prioritize, with varying accuracy, the number of children treated (e.g., with fluoride varnish in the medical setting) and/or referred compared to the “universal” recommendations supported by current policies. The percentage of children treated/referred as higher risk would be 48% using a score of 5 as the cutoff threshold for risk and 85% for a score of 3. The choice of score threshold to use would depend on how the tool is being used in practice.