Abstract
ObjectivesTo identify predictors in patient profiles, and to develop, internally validate, and calibrate prediction models for the persistence of self-reported orofacial pain at the 6-month and 12-month follow-up in patients with myofascial pain.Materials and methodsA cohort of 63 adult patients with moderate to severe chronic myofascial pain was included. Patient and disease characteristics at baseline were recorded as potential predictors. Patients` presence or absence of improvement of orofacial pain at follow-up was considered the outcome. Binary logistic regression analyses were used to develop the models. The performance and clinical values of the models were determined.ResultsForty-three percent and 30% of the patients had persistence of orofacial pain at 6-month and 12-month follow-up, respectively. Pain elsewhere, depression, parafunctional activities, and mandibular function impairment (MFI) were significantly associated with persistence of the pain at 6-month follow-up, whereas depression, parafunctional activities, and MFI were significantly associated with persistence of the pain at 12-month follow-up. Both of the models showed good calibration and discrimination, with shrunken area under the curve (AUC) values of 0.73 and 0.76, respectively. The clinical added predictive values for ruling in the risk of the persistence were 0.30 and 0.31, respectively, and those for ruling it out were 0.25 and 0.20, respectively.ConclusionsPotential predictors for prediction of the persistence of self-reported orofacial pain at follow-up were identified. The calibration, discrimination, and clinical values of the models were acceptable.Clinical relevanceThe models may assist clinicians in decision-making regarding the improvement of orofacial pain of individual patients during follow-up in clinical settings.
Highlights
Temporomandibular disorders (TMD) consist of a group of disorders involving the temporomandibular joint (TMJ), masticatory muscles, or both [1]
Van Grootel et al [16] reported that 6 and 12 out of 27 patients with myofascial pain showed no significant improvement in orofacial pain due to relapse at 6-month and 12-month follow-up after the completion of physiotherapy, respectively, whereas 5 and 8 out of 29 patients showed no significant improvement in orofacial pain due to relapse in 6-month and 12-month follow-up after the completion of splint, respectively
We developed a clinical rule for prediction of the persistence of orofacial pain in the present study as to provide an estimate for individual patients of their absolute risk of the persistence of orofacial pain at the follow-up
Summary
Temporomandibular disorders (TMD) consist of a group of disorders involving the temporomandibular joint (TMJ), masticatory muscles, or both [1]. Up to 80% of the patients with complaints of myofascial pain seek for consultation to get relieved from this pain [6] This high percentage may be due to the fact that this type of orofacial pain affects patients directly by hurting them physically, but the condition is associated with a variety of psychosocial and behavioral comorbid conditions, like depression and catastrophizing. Van Grootel et al [16] reported that 6 and 12 out of 27 patients with myofascial pain showed no significant improvement in orofacial pain due to relapse at 6-month and 12-month follow-up after the completion of physiotherapy, respectively, whereas 5 and 8 out of 29 patients showed no significant improvement in orofacial pain due to relapse in 6-month and 12-month follow-up after the completion of splint, respectively. This may provide clinicians with important information for their decision-making for the management of individual patients in health care at follow-up
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