Inter-rater reliability of the Mallampati classification for patients in a dental hygiene clinic.

PURPOSE: The purpose of this study was to assess the inter-rater reliability between dental hygiene students and a supervising dentist using the Mallampati classification to evaluate and classify the pharyngeal soft tissues. METHODS: A sample of 234 patients volunteered for the study. Mallampati classifications were performed by 21 dental hygiene students for patients during a 12 month period. During that same time period, the clinic dentist performed an independent assessment on the same patients. Quantitative research methods were used to evaluate the inter-rater reliability between dental hygiene students and the clinical dentist in performing the Mallampati classification. The data was analyzed using adjusted McNemar test for non-independent data, Kappa score and percentage of agreement with 95% bootstrap confidence interval. RESULTS: There was an agreement between the dental hygiene student and the dentist in the majority of the independent assessments with a p-value=0.498 from the adjusted McNemar test. Inter-rater agreement measured by Cohen's Kappa coefficient was 0.54 with a 95% bootstrap confidence interval of 0.42, 0.64. The percentage agreement was around 77% with a 95% confidence interval of 72%, 82%. CONCLUSION: It was concluded that dental hygiene students can evaluate and classify the pharyngeal soft tissues comparable to a supervising dentist in the clinical dental hygiene setting.

Age of inhalant first time use and its association to the use of other drugs.

Inhalants are the 4th most commonly abused drugs after alcohol, tobacco, and marijuana. Although inhalants are often referred as Gateway Drugs this hypothesis is less examined. Using the 2003 National Survey on Drug Use and Health data, age of first time inhalant use was compared with the age of onset of other drugs among 6466 inhalant users who also used at least one of 14 other drugs. Findings indicated that only 4.2% multiple drug users who used inhalants prior to other drugs, especially alcohol, tobacco, and marijuana. Thus, the theory that inhalants are gateway drugs was not supported.

Influence of credentials of clinical laboratory professionals on proficiency testing performance.

The influence of the training, experience, and credentials of testing personnel in the increasingly complex laboratory is a significant concern. A retrospective study compared the relationship of proficiency testing (PT) performance with the credentials of the testing personnel using logistic regression analyses. Predictor variables included the practitioner's college major, degree, certification, and years of laboratory experience. There were 14,326 valid PT results and 359 practitioners of whom 245 (68.2%) had a clinical laboratory science major. Logistic regression analysis revealed that participants without a clinical laboratory science major were more likely (adjusted odds ratio, 1.849; P = .035) to produce unacceptable results compared with participants whose academic history included a clinical laboratory science program. These data suggest that clinical laboratories should be staffed by people who have completed a formal clinical laboratory education program to ensure quality of laboratory testing and to reduce the risk of medical errors.