Abstract
Temporomandibular disorders (TMD) screeners assume significant item overlap with the screening questionnaire proposed by the American Academy of Orofacial Pain (AAOP).ObjectiveTo test the reliability and validity of the Portuguese version of AAOP questions for TMD screening among adolescents.Material and MethodsDiagnoses from Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis I were used as reference standard. Reliability was evaluated by internal consistency (KR-20) and inter-item correlation. Validity was tested by sensitivity, specificity, predictive values, accuracy and receiver operating characteristic (ROC) curves, the relationship between the true-positive rate (sensitivity) and the false-positive rate (specificity). Test-retest reliability of AAOP questions and intra-examiner reproducibility of RDC/TMD Axis I were tested with kappa statistics.ResultsThe sample consisted of 1307 Brazilian adolescents (56.8% girls; n=742), with mean age of 12.72 years (12.69 F/12.75 M). According to RDC/TMD, 397 [30.4% (32.7% F/27.3% M)] of adolescents presented TMD, of which 330 [25.2% (27.6% F/22.2% M)] were painful TMD. Because of low consistency, items #8 and #10 of the AAOP questionnaire were excluded. Remaining items (of the long questionnaire version) showed good consistency and validity for three positive responses or more. After logistic regression, items #4, #6, #7 and #9 also showed satisfactory consistency and validity for two or more positive responses (short questionnaire version). Both versions demonstrated excellent specificity (about 90%), but higher sensitivity for detecting painful TMD (78.2%). Better reproducibility was obtained for the short version (k=0.840).ConclusionsThe Portuguese version of AAOP questions showed both good reliability and validity for the screening of TMD among adolescents, especially painful TMD, according to RDC/TMD.
Highlights
Advances in the understanding regarding the prevalence, etiology and natural progression for temporomandibular disorders (TMD), as well as for the establishment of their treatment strategies, are dependent on reliable and valid diagnostic criteria26.there has been notable development of screeners for both clinical and epidemiological purposes
The diagnoses obtained by Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis I preseted a total of 397 [30.4% (32.7% F/27.3% M)] adolescents diagnosed positively for any TMD subtype
Today, revised criteria, known as Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), have been presented25, but the older RDC/TMD continue the most acceptable and well-known standard for diagnosing TMD in researches, and that is the reason they selected as reference standard in this study, as it has previously been done by others4,21,30
Summary
Advances in the understanding regarding the prevalence, etiology and natural progression for temporomandibular disorders (TMD), as well as for the establishment of their treatment strategies, are dependent on reliable and valid diagnostic criteria26.there has been notable development of screeners for both clinical and epidemiological purposes. The Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) were presented in 1992 to promote standardization and replication of research on TMD. They enable clinical researchers to classify TMD subtypes in a similar manner in different countries and languages. The RDC/TMD have been tested in many studies and, their qualities of accuracy, validity and reliability have been demonstrated, a new version has recently been proposed. The RDC/TMD have been tested in many studies and, their qualities of accuracy, validity and reliability have been demonstrated, a new version has recently been proposed25 They have been applied in countless researches; they are GLI¿FXOW WR DSSO\ LQ ODUJH HSLGHPLRORJLFDO VWXGLHV because the protocols are long, time-consuming and require a face-to-face evaluation
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