Title: Detection and diagnosis of common oral diseases: Diagnostic test accuracy of tests of oral cancer and caries
Funder: Department of Health and Social Care

Abstract: Background: Around 95% of the UK annual budget for NHS dentistry is spent on providing services in primary care by general dental practitioners (GDPs). More than two-thirds of dental care relates to the routine dental “check-up”. Two important components of the "check-up" are the detection and diagnosis of dental caries, and of oral squamous cell carcinoma (OSCC) and potentially malignant disorders (PMD). Aims: (1) To establish the accuracy of the different methods of detecting and diagnosing tooth decay; (2) to establish the accuracy of different methods for screening, detecting and diagnosing oral squamous cell carcinoma and potentially malignant disorders. This research will provide answers to the questions ‘which methods should I use to diagnose disease’ and ‘in which settings and with which populations should they be used?’ Methods: We will undertake a suite of systematic reviews of diagnostic test accuracy (DTA) following Cochrane methods devised for the conduct of the DTA reviews. We will complete a new review for each identified method for the detection and diagnosis of dental caries (six reviews in total); and one new review of the comparative accuracy of the identified methods, used alone or in combination, exploring the comparative accuracy of all available techniques. In addition, we will update our two existing Cochrane DTA reviews on the screening and diagnosis of OSCC and PMD. Results/Dissemination: We will place our findings in the context of our existing Cochrane Oral Health (COH) effectiveness reviews on caries and cancer, to inform the clinical care pathway from detection, through diagnosis to treatment. We will have continued engagement with guideline development groups from the start of the project to promote the use of the findings of the reviews in future guideline documents. We will also meet with representatives from relevant charities to discuss the results of our work and the implications of our findings.

Lay abstract: Background: Around 95% of the UK annual budget for NHS dentistry is spent on providing services in primary care by general dental practitioners (GDPs). More than two-thirds of dental care relates to the routine dental “check-up”. During a "check-up", the dentist will look for signs of dental caries (tooth decay), oral squamous cell carcinoma (oral cancer), and potentially malignant disorders (oral disorders that could become cancerous). Aims: (1) To find out the accuracy of the different methods of detecting and diagnosing tooth decay; (2) to find out the accuracy of different methods for screening, detecting and diagnosing oral squamous cell carcinoma and potentially malignant disorders. This research will provide answers to the questions ‘which methods should I use to diagnose disease’ and ‘in which settings and with which patients should they be used?’ Methods: We will use a research method known as systematic reviewing to look at the performance of different methods, using processes devised by Cochrane. We will complete six reviews for the detection and diagnosis of dental caries and one review that will compare the accuracy of the different methods against each other. Also, we will update our two reviews on the screening and diagnosis of oral squamous cell carcinoma and potentially malignant disorders. Results/Dissemination: This research will provide patients, dentists and policy makers with high-quality information on the different methods available. We will place our findings together with our existing Cochrane Oral Health (COH) reviews on caries and cancer so that we can link research on the diagnosis of disease with research on treatment. This will inform how patients are cared for. We will regularly meet with guideline development groups to ensure that the findings of the reviews are used in guidelines for clinical practice. We will also meet with representatives from relevant charities to discuss the results of our work and the implications of our findings.

Research activity codes: 4.2 EVALUATION OF MARKERS AND TECHNOLOGIES
Health categories: CANCER AND NEOPLASMS;ORAL AND GASTROINTESTINAL