Researchers’ perceptions and practices regarding the calibration process in malocclusion studies: a qualitative-quantitative study

Abstract

Introduction: Calibration is essential in studies on malocclusion because it contributes to diagnostic standardization and the reliability of results. Objective: To assess researchers’ perceptions and practices regarding the calibration process in clinical and epidemiological studies related to malocclusion. Material and method: An observational, cross-sectional, mixed-methods study was conducted with 50 researchers from the fields of Orthodontics, Pediatric Dentistry, and Orthodontics in Public Health. Data were collected through an online questionnaire administered between May 2021 and May 2022. The target population was defined based on the identification of graduate programs using an open-data platform, a literature search for epidemiological studies on malocclusion, and prior mapping of researchers in the field. Data were analyzed descriptively. Result: Among the participants, 24 reported previous experience with calibration and comprised the analytical sample. Heterogeneity was observed in the conduct of the calibration process, particularly regarding the number of examiners, training duration, interval between training and agreement assessment, and instruments used to assess malocclusion. Nevertheless, most researchers recognized the relevance of this stage, assigning high importance to calibration and emphasizing its contribution to ensuring the reliability, validity, and reproducibility of results. The Kappa statistic was the most commonly used method for assessing inter-examiner agreement. Conclusion: Calibration still presents methodological weaknesses and a lack of uniformity, which may compromise comparability across studies. These findings reinforce the need for clearer guidelines to standardize this stage in malocclusion research.