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Introduction: Orthodontics in China has developed rapidly, but there is no standard index of treatment outcomes. We assessed the validity of the American Board of Orthodontics Objective Grading System (ABO-OGS) for the classification of treatment outcomes in Chinese patients., Methods: We randomly selected 108 patients who completed treatment between July 2005 and September 2008 in 6 orthodontic treatment centers across China. Sixty-nine experienced Chinese orthodontists made subjective assessments of the end-of-treatment casts for each patient. Three examiners then used the ABO-OGS to measure the casts. Pearson correlation analysis and receiver operating characteristic curve analysis were conducted to evaluate the correspondence between the ABO-OGS cast measurements and the orthodontists' subjective assessments., Results: The average subjective grading scores were highly correlated with the ABO-OGS scores (r = 0.7042). Four of the 7 study cast components of the ABO-OGS score-occlusal relationship, overjet, interproximal contact, and alignment-were statistically significantly correlated with the judges' subjective assessments. Together, these 4 accounted for 58% of the variability in the average subjective grading scores. The ABO-OGS cutoff score for cases that the judges deemed satisfactory was 16 points; the corresponding cutoff score for cases that the judges considered acceptable was 21 points., Conclusions: The ABO-OGS is a valid index for the assessment of treatment outcomes in Chinese patients. By comparing the objective scores on this modification of the ABO-OGS with the mean subjective assessment of a panel of highly qualified Chinese orthodontists, a cutoff point for satisfactory treatment outcome was defined as 16 points or fewer, with scores of 16 to 21 points denoting less than satisfactory but still acceptable treatment. Cases that scored greater than 21 points were considered unacceptable., (Copyright © 2013 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.)

Introduction: This study continues our assessment of agreement and disagreement among 25 Chinese and 20 US orthodontists in the ranking for facial attractiveness of end-of-treatment photographs of randomly sampled growing Chinese and white orthodontic patients. The main aims of this article were to (1) measure the overall pattern of agreement between the mean rankings of US and Chinese orthodontists, and (2) measure the strength of agreement between the rankings of the US and Chinese orthodontists for each patient., Methods: Each judge independently ranked standard clinical sets of profile, frontal, and frontal-smiling photographs of 43 US patients and 48 Chinese patients. For each patient, a separate mean rank was computed from the responses of each group of judges. Pearson correlations between the mean ranks of the 2 groups of judges were used to measure their overall agreement. Paired and unpaired t tests were used to measure the agreement between the judges of the 2 groups for each patient., Results: The overall agreement between the mean rankings of the US and Chinese judges was very high. For the US patients, the correlation between the Chinese and US judges means was r = 0.92, P <0.0001. For the Chinese patients, the analogous value was r = 0.86, P <0.0001. Agreement between the 2 groups of judges concerning each patient was also generally strong. For two thirds of the patients, the mean ranks of the US and Chinese judges differed by less than 1 unit in a scale of 12. However, for 6 patients considered individually (5 Chinese and 1 US), the assessment of the 2 groups of judges was statistically significantly different at P values ranging from 0.02 to less than 0.0001, even after the Bonferroni correction., Conclusions: These findings demonstrate that orthodontic clinicians can reliably identify and rank subtle differences between patients, and that differences between judges and between patients can be distinguished at a high level of statistical significance, given appropriate study designs. However, the reasons clinicians give for the differences in their judgments are more difficult to investigate and will require further study.

Introduction: In this study, we assessed agreement and disagreement among pairs of Chinese and US orthodontists in the ranking for "facial attractiveness" of end-of-treatment photographs of growing Chinese and white orthodontic patients., Methods: Two groups of orthodontist-judges participated: from the University of the Pacific, School of Dentistry, in California and from Peking University School and Hospital of Stomatology in China. Each judge independently ranked standard clinical sets of profile, frontal, and frontal-smiling photographs of 43 white patients and 48 Chinese patients. Pearson correlations were generated for a total of 1980 rankings by pairs of judges., Results: The resulting correlations ranged from +0.004 to +0.96 with a median of +0.54. Of these, 18.7% were lower than 0.4; 41.0% were lower than 0.5; 68.8% were lower than 0.6; 91.6% were lower than 0.7; and only 8.4% were greater than 0.7. As had been anticipated, correlations between judges were higher when they ranked patients of their own ethnicity than when they ranked patients of different ethnicity, but the differences were smaller than had been expected. The rankings of no pair of judges correlated negatively. This is to say that no pair of judges, whether of the same or different ethnicity, ranked the patients so that those 1 judge tended to find attractive were consistently found unattractive by the other., Conclusions: The distribution of levels of agreement between pairs of orthodontists did not differ substantially whether the pairs included 2 US orthodontists, 2 Chinese orthodontists, or 1 US and 1 Chinese orthodontist. As might be expected, the pairs of Chinese orthodontists agreed with each other slightly better on average when ranking Chinese patients, and the pairs of US orthodontists agreed with each other slightly better on average when ranking white American patients, but the overall differences were small. These findings appear consistent with the inference that, on average, judgments of "facial attractiveness" by orthodontists at the 2 venues are more similar than had been expected for patients of Chinese and white ethnicity.