Accuracy of diagnoses of HIV-related oral lesions by medical clinicians, Findings from the Women's Interagency HIV Study

Joan F. Hilton, Mario Alves, Kathryn Anastos, Alison J. Canchola, Mardge Cohen, Robert Delapenha, Deborah Greenspan, Alexandra Levine, Laurie A. MacPhail, Sandra J. Micci, Roseann Mulligan, Mahvesh Navazesh, Joan Phelan, Peter Tsaknis

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Objective: To determine if medical clinicians are as accurate as dental clinicians in recognizing diagnostic characteristics of HIV-related oral lesions. Methods: In 355 HIV-infected participants at five Women's Interagency HIV Study sites, we paired oral examinations conducted within 7 days of each other by dental and medical clinicians. We used the former as a gold standard against which to evaluate the accuracy of the latter. We assessed the accuracy of the medical clinicians' findings based both on their observations of abnormalities and on their descriptions of these abnormalities. Results: Dental clinicians diagnosed some oral abnormality in 38% of participants. When "abnormality" was used as the medical clinicians' outcome, sensitivities were 75% for pseudomembranous candidiasis and 58% for erythematous candidiasis, but only 40% for hairy leukoplakia. When a precise description of the abnormality was used as their outcome, sensitivities were 19%, 12% and 20%, respectively. Conclusions: Medical clinicians recognize that HIV-related oral abnormalities are present in 40-75% of cases, but less often describe them accurately. Low sensitivity implies that the true associations of specific oral lesions with other HIV phenomena, such as time until AIDS, must be stronger than the literature suggests.

Original languageEnglish (US)
Pages (from-to)362-372
Number of pages11
JournalCommunity Dentistry and Oral Epidemiology
Volume29
Issue number5
StatePublished - 2001
Externally publishedYes

Fingerprint

Mouth Abnormalities
HIV
Tooth
Candidiasis
Hairy Leukoplakia
Oral Diagnosis
Acquired Immunodeficiency Syndrome

Keywords

  • Aids-related opportunistic infections, epidemiology
  • Mouth diseases
  • Primary health care, statistics & numerical data
  • Women's health

ASJC Scopus subject areas

  • Dentistry(all)

Cite this

Accuracy of diagnoses of HIV-related oral lesions by medical clinicians, Findings from the Women's Interagency HIV Study. / Hilton, Joan F.; Alves, Mario; Anastos, Kathryn; Canchola, Alison J.; Cohen, Mardge; Delapenha, Robert; Greenspan, Deborah; Levine, Alexandra; MacPhail, Laurie A.; Micci, Sandra J.; Mulligan, Roseann; Navazesh, Mahvesh; Phelan, Joan; Tsaknis, Peter.

In: Community Dentistry and Oral Epidemiology, Vol. 29, No. 5, 2001, p. 362-372.

Research output: Contribution to journalArticle

Hilton, JF, Alves, M, Anastos, K, Canchola, AJ, Cohen, M, Delapenha, R, Greenspan, D, Levine, A, MacPhail, LA, Micci, SJ, Mulligan, R, Navazesh, M, Phelan, J & Tsaknis, P 2001, 'Accuracy of diagnoses of HIV-related oral lesions by medical clinicians, Findings from the Women's Interagency HIV Study', Community Dentistry and Oral Epidemiology, vol. 29, no. 5, pp. 362-372.
Hilton, Joan F. ; Alves, Mario ; Anastos, Kathryn ; Canchola, Alison J. ; Cohen, Mardge ; Delapenha, Robert ; Greenspan, Deborah ; Levine, Alexandra ; MacPhail, Laurie A. ; Micci, Sandra J. ; Mulligan, Roseann ; Navazesh, Mahvesh ; Phelan, Joan ; Tsaknis, Peter. / Accuracy of diagnoses of HIV-related oral lesions by medical clinicians, Findings from the Women's Interagency HIV Study. In: Community Dentistry and Oral Epidemiology. 2001 ; Vol. 29, No. 5. pp. 362-372.
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AU - Alves, Mario

AU - Anastos, Kathryn

AU - Canchola, Alison J.

AU - Cohen, Mardge

AU - Delapenha, Robert

AU - Greenspan, Deborah

AU - Levine, Alexandra

AU - MacPhail, Laurie A.

AU - Micci, Sandra J.

AU - Mulligan, Roseann

AU - Navazesh, Mahvesh

AU - Phelan, Joan

AU - Tsaknis, Peter

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N2 - Objective: To determine if medical clinicians are as accurate as dental clinicians in recognizing diagnostic characteristics of HIV-related oral lesions. Methods: In 355 HIV-infected participants at five Women's Interagency HIV Study sites, we paired oral examinations conducted within 7 days of each other by dental and medical clinicians. We used the former as a gold standard against which to evaluate the accuracy of the latter. We assessed the accuracy of the medical clinicians' findings based both on their observations of abnormalities and on their descriptions of these abnormalities. Results: Dental clinicians diagnosed some oral abnormality in 38% of participants. When "abnormality" was used as the medical clinicians' outcome, sensitivities were 75% for pseudomembranous candidiasis and 58% for erythematous candidiasis, but only 40% for hairy leukoplakia. When a precise description of the abnormality was used as their outcome, sensitivities were 19%, 12% and 20%, respectively. Conclusions: Medical clinicians recognize that HIV-related oral abnormalities are present in 40-75% of cases, but less often describe them accurately. Low sensitivity implies that the true associations of specific oral lesions with other HIV phenomena, such as time until AIDS, must be stronger than the literature suggests.

AB - Objective: To determine if medical clinicians are as accurate as dental clinicians in recognizing diagnostic characteristics of HIV-related oral lesions. Methods: In 355 HIV-infected participants at five Women's Interagency HIV Study sites, we paired oral examinations conducted within 7 days of each other by dental and medical clinicians. We used the former as a gold standard against which to evaluate the accuracy of the latter. We assessed the accuracy of the medical clinicians' findings based both on their observations of abnormalities and on their descriptions of these abnormalities. Results: Dental clinicians diagnosed some oral abnormality in 38% of participants. When "abnormality" was used as the medical clinicians' outcome, sensitivities were 75% for pseudomembranous candidiasis and 58% for erythematous candidiasis, but only 40% for hairy leukoplakia. When a precise description of the abnormality was used as their outcome, sensitivities were 19%, 12% and 20%, respectively. Conclusions: Medical clinicians recognize that HIV-related oral abnormalities are present in 40-75% of cases, but less often describe them accurately. Low sensitivity implies that the true associations of specific oral lesions with other HIV phenomena, such as time until AIDS, must be stronger than the literature suggests.

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