TY - JOUR
T1 - Assessment of a decision making protocol to improve the efficacy of VELscope™ in general dental practice
T2 - A prospective evaluation
AU - Bhatia, Nirav
AU - Matias, Marie Anne T.
AU - Farah, Camile S.
PY - 2014/10/1
Y1 - 2014/10/1
N2 - Background VELscope™ is a device designed to help detect potentially malignant disorders of the oral mucosa at an early stage using direct tissue autofluorescence. Previous research indicates a high rate of false positives using this device. This study assesses a decision making protocol for the detection of oral mucosal lesions using conventional oral examination and VELscope™ in a general dental practice setting. Materials and methods 305 patients presenting for general dental treatment were screened by a general dental practitioner (GDP) for oral mucosal lesions using incandescent light (conventional oral examination - COE), followed by VELscope™ and then by correlating the findings from these two examinations. A decision making protocol was followed. Patients were either reviewed or referred to an Oral Medicine specialist (OMS) for consultation, and biopsy was undertaken as required for definitive diagnosis. Results 146 patients presented with at least one oral mucosal lesion, and a total of 222 lesions were detected. COE detected 161 oral mucosal lesions and an additional 61 lesions were detected with VELscope™. COE alone showed a sensitivity of 44.0% and specificity of 99.0% while VELscope™ alone showed a sensitivity of 64.0% and specificity of 54.3%. Using the decision making protocol, the sensitivity and specificity were 73.9% and 97.9% respectively. Conclusion Using the decision making protocol proposed in this study allows for the detection of additional oral mucosal lesions requiring specialist referral by incorporating VELscope™ into routine general dental practice, without compromising patient care.
AB - Background VELscope™ is a device designed to help detect potentially malignant disorders of the oral mucosa at an early stage using direct tissue autofluorescence. Previous research indicates a high rate of false positives using this device. This study assesses a decision making protocol for the detection of oral mucosal lesions using conventional oral examination and VELscope™ in a general dental practice setting. Materials and methods 305 patients presenting for general dental treatment were screened by a general dental practitioner (GDP) for oral mucosal lesions using incandescent light (conventional oral examination - COE), followed by VELscope™ and then by correlating the findings from these two examinations. A decision making protocol was followed. Patients were either reviewed or referred to an Oral Medicine specialist (OMS) for consultation, and biopsy was undertaken as required for definitive diagnosis. Results 146 patients presented with at least one oral mucosal lesion, and a total of 222 lesions were detected. COE detected 161 oral mucosal lesions and an additional 61 lesions were detected with VELscope™. COE alone showed a sensitivity of 44.0% and specificity of 99.0% while VELscope™ alone showed a sensitivity of 64.0% and specificity of 54.3%. Using the decision making protocol, the sensitivity and specificity were 73.9% and 97.9% respectively. Conclusion Using the decision making protocol proposed in this study allows for the detection of additional oral mucosal lesions requiring specialist referral by incorporating VELscope™ into routine general dental practice, without compromising patient care.
KW - Early detection of cancer
KW - Fluorescence imaging
KW - Oral cancer
KW - Precancerous conditions
KW - Sensitivity and specificity
UR - http://www.scopus.com/inward/record.url?scp=84907878238&partnerID=8YFLogxK
U2 - 10.1016/j.oraloncology.2014.07.002
DO - 10.1016/j.oraloncology.2014.07.002
M3 - Article
C2 - 25096826
AN - SCOPUS:84907878238
SN - 1368-8375
VL - 50
SP - 1012
EP - 1019
JO - Oral Oncology
JF - Oral Oncology
IS - 10
ER -