Document Detail

Interobserver variability in assessment of signs of TMD.
MedLine Citation:
PMID:  11484576     Owner:  NLM     Status:  MEDLINE    
PURPOSE: The aim of this report was to study the ability of examiners to measure reliably the clinical signs of temporomandibular disorders (TMD). Four examiners participated in this study of 11 TMD patients and 25 nonpatients. MATERIALS AND METHODS: Vertical and lateral excursions of the jaw were measured using a millimeter ruler. Joint sounds during vertical jaw movements were assessed using digital palpation. The reliability of delivering appropriate degrees of digital pressure to assess masticatory muscle pain was assessed using a manometer after training examiners to exert specified pressures. RESULTS: Intraclass correlation coefficients for the measurement of vertical and protrusive jaw movements were > or = 0.87, which was considered excellent. The intraclass correlation coefficient for measurements of left and right lateral jaw excursions varied between 0.73 and 0.85, which was considered acceptable. The interobserver agreement for detecting the joint sounds showed overall agreement across examiners of 78%. Kappa for every possible pair of examiners varied between .52 and .86 (median .75, interquartile range .18). Reliability for diagnostic categories from the Helkimo index and Research Diagnostic Criteria for Temporomandibular Disorders involving joint noises showed modest reliability. CONCLUSION: Point estimates and measures of spread for reliability measures of single clinical TMD signs as well as combinations of signs into diagnostic categories from the Helkimo index and Research Diagnostic Criteria for Temporomandibular Disorders involving joint noises were sufficient in a group of four examiners.
M T John; A J Zwijnenburg
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The International journal of prosthodontics     Volume:  14     ISSN:  0893-2174     ISO Abbreviation:  Int J Prosthodont     Publication Date:    2001 May-Jun
Date Detail:
Created Date:  2001-08-03     Completed Date:  2001-12-14     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8900938     Medline TA:  Int J Prosthodont     Country:  United States    
Other Details:
Languages:  eng     Pagination:  265-70     Citation Subset:  D    
Department of Prosthodontics, Martin Luther University Halle-Wittenberg, Grosse Steinstrasse 19, 06108 Halle, Saale, Germany.
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MeSH Terms
Chi-Square Distribution
Facial Pain / physiopathology
Mandible / physiopathology
Masticatory Muscles / physiopathology
Middle Aged
Observer Variation
Range of Motion, Articular / physiology
Reproducibility of Results
Statistics as Topic
Temporomandibular Joint / physiopathology
Temporomandibular Joint Disorders / classification*,  physiopathology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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