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Objective: Determine optimal weightings of Peer Assessment Rating (PAR) index and Discrepancy Index (DI) for malocclusion severity assessment in Chinese orthodontic patients., Methods: Sixty-nine Chinese orthodontists assessed a full set of pre-treatment records from a stratified random sample of 120 subjects gathered from six university orthodontic centres. Using professional judgment as the outcome variable, multiple regression analyses were performed to derive customized weighting systems for the PAR index and DI, for all subjects and each Angle classification subgroup., Results: Professional judgment was consistent, with an Intraclass Correlation Coefficient (ICC) of 0.995. The PAR index or DI can be reliably measured, with ICC = 0.959 and 0.990, respectively. The predictive accuracy of PAR index was greatly improved by the Chinese weighting process (from r = 0.431 to r = 0.788) with almost equal distribution in each Angle classification subgroup. The Chinese-weighted DI showed a higher predictive accuracy, at P = 0.01, compared with the PAR index (r = 0.851 versus r = 0.788). A better performance was found in the Class II group (r = 0.890) when compared to Class I (r = 0.736) and III (r = 0.785) groups., Conclusions: The Chinese-weighted PAR index and DI were capable of predicting 62 per cent and 73 per cent of total variance in the professional judgment of malocclusion severity in Chinese patients. Differential prediction across Angle classifications merits attention since different weighting formulas were found.

Since the end of World War II, the practice of dentistry has been largely transformed from a "calling" into a cog in the ever-expanding "Healthcare Industry". In the process, the distinction between professional ethics and the ethics of commerce has been attenuated and, to a large extent, lost. Today's dentist is faced with an inherent conflict between the pledge of the health professional to hold the patient's interests primary (and above all, to do no harm), and the self-protective commercial principle of caveat emptor. Pressures towards commercialism come from the government and the insurance industry, the increasingly unfavorable ratio between professional fees and the cost of production, and the high cost of dental education. Viewed simplistically, much of dentistry today has an outward form resembling commodity production. Recognizing the substantial forces tending to attenuate ethical standards in our profession may aid us in resisting their encroachments.