Research Article| Volume 64, ISSUE 6, P751-756, December 1987

Interpretation of bitewing radiographs: Application of the kappa statistic to determine rater agreements

      This paper is only available as a PDF. To read, Please Download here.


      The interrater agreement of 34 dentists in determining the presence or absence of caries and the depth of caries in bitewing radiographs was studied. The kappa statistic was used to determine rater agreement, and results indicate that there was substantial agreement on the presence or absence of caries and only fair agreement on the specific depth of caries. Because of the degree of disagreement in determination of the extent of caries among examiners, it is recommended that this fact be taken into account in relation to the findings on bitewing radiographs, particularly when there may be differences of opinion between parties.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


        • Trithart A.H.
        • Donnelly C.J.
        A comparative study of proximal cavities found by clinical and roentgenographic examinations.
        J Am Dent Assoc. 1950; 40: 33-37
        • Barr J.
        • Gresham A.H.
        The detection of carious lesions on proximal surfaces of teeth.
        J Am Dent Assoc. 1950; 41: 198-204
        • Galagan D.J.
        • Vermillion J.
        Diagnosis of caries by radiographic interpretation.
        J Dent Res. 1956; 35: 33-38
        • Murray J.D.
        • Shaw L.
        Errors in diagnosis of approximal caries on bitewing radiographs.
        Community Dent Oral Epidemiol. 1975; 3: 276-282
        • Backer Dirks O.
        • van Amerogen J.
        • Winkler K.C.
        A reproducible method for caries evaluation.
        J Dent Res. 1951; 30: 346-359
        • Goldstein I.L.
        • Mobley W.H.
        • Chellemi S.J.
        The observer process in the visual interpretation of radiographs.
        J Dent Educ. 1971; 35: 21-27
        • DePaola P.F.
        • Alman J.
        Assessment of the reliability of radiographic diagnosis in a clinical caries trial.
        J Dent Res. 1972; 51: 1431-1437
        • Gro¨ndahl H.
        Radiographic caries diagnosis—a study of caries progression and observer performance.
        Swed Dent J. 1979; 1–6 (Go¨teborg): 1-32
        • Bailit H.L.
        • Reisine S.T.
        • Damuth R.L.
        • Richards N.P.
        The validity of the radiographic method in the pretreatment review of dental claims.
        J Public Health Dent. 1980; 40: 26-38
        • Manson-Hing L.R.
        Vision and oral roentgenology.
        Oral Surg Oral Med Oral Pathol. 1962; 15: 173-183
        • Fleiss J.L.
        Measuring normal scale agreement among many raters.
        Psychol Bull. 1971; 76: 378-382
        • Fleiss J.L.
        • Fischman S.L.
        • Chilton N.W.
        • Park M.H.
        Reliability of discrete measurements in caries trials.
        Caries Res. 1979; 13: 23-31
        • Fleiss J.L.
        • Nee J.C.M.
        • Landis J.R.
        Large sample variance of kappa in the case of different sets of raters.
        Psychol Bull. 1979; 86: 974-977
        • Brennen R.L.
        • Prediger D.J.
        Coefficient kappa: some uses, misuses, and alternatives.
        Educ & Psychol Meas. 1981; 41: 687-699
        • Landis J.R.
        • Koch G.G.
        The measurement of observer agreement for categorical data.
        Biometrics. 1977; 33 (Table I adapted with permission from the Biometric Society): 159-174
        • Fleiss J.L.
        • Cicchetti D.V.
        Inference about weighted kappa in the non-null case.
        Appl Psychol Meas. 1978; 2: 113-117