Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2010 Winter;24(1):63-78.

The Research Diagnostic Criteria for Temporomandibular Disorders. V: methods used to establish and validate revised Axis I diagnostic algorithms

Eric L Schiffman  1 , Richard Ohrbach, Edmond L Truelove, Feng Tai, Gary C Anderson, Wei Pan, Yoly M Gonzalez, Mike T John, Earl Sommers, Thomas List, Ana M Velly, Wenjun Kang, John O Look
Affiliations

The Research Diagnostic Criteria for Temporomandibular Disorders. V: methods used to establish and validate revised Axis I diagnostic algorithms

Eric L Schiffman et al. J Orofac Pain. 2010 Winter.

Abstract

Aims: To derive reliable and valid revised Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis I diagnostic algorithms for clinical TMD diagnoses.

Methods: The multisite RDC/TMD Validation Project's dataset (614 TMD community and clinic cases, and 91 controls) was used to derive revised algorithms for Axis I TMD diagnoses. Validity of diagnostic algorithms was assessed relative to reference standards, the latter based on consensus diagnoses rendered by two TMD experts using criterion examination data, including temporomandibular joint imaging. Cutoff points for target validity were sensitivity > or = 0.70 and specificity > or = 0.95. Reliability of revised algorithms was assessed in 27 study participants.

Results: Revised algorithm sensitivity and specificity exceeded the target levels for myofascial pain (0.82, 0.99, respectively) and myofascial pain with limited opening (0.93, 0.97). Combining diagnoses for any myofascial pain showed sensitivity of 0.91 and specificity of 1.00. For joint pain, target sensitivity and specificity were observed (0.92, 0.96) when arthralgia and osteoarthritis were combined as "any joint pain." Disc displacement without reduction with limited opening demonstrated target sensitivity and specificity (0.80, 0.97). For the other disc displacement diagnoses, osteoarthritis and osteoarthrosis, sensitivity was below target (0.35 to 0.53), and specificity ranged from 0.80 to meeting target. Kappa for revised algorithm diagnostic reliability was > or =0.63.

Conclusion: Revised RDC/TMD Axis I TMD diagnostic algorithms are recommended for myofascial pain and joint pain as reliable and valid. However, revised clinical criteria alone, without recourse to imaging, are inadequate for valid diagnosis of two of the three disc displacements as well as osteoarthritis and osteoarthrosis.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Revised Group I Muscle Disorders diagnostic algorithm (expert-driven).
Figure 2
Figure 2
Revised Group II Disc Displacements diagnostic algorithm (expert-driven).
Figure 3
Figure 3
Revised Group III Arthralgia, Arthritis, and Arthrosis diagnostic algorithm (expert-driven).
See this image and copyright information in PMC

Comment in

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Dworkin SF, LeResche L. Research diagnostic criteria for temporomandibular disorders: Review criteria, examinations and specifications, critique. J of Craniomandib Dis. 1992;6:301–355. - PubMed
    1. Truelove E, Pan W, Look J, Mancl L, Ohrbach R, Velly A, John MT, Schiffman EL. Research Diagnostic Criteria for Temporomandibular Disorders: Validity of Axis I Diagnoses. J Orofac Pain. 2009 in revision. - PMC - PubMed
    1. Schiffman EL, Truelove E, Ohrbach R, Anderson G, John MT, List T, et al. Assessment of the Validity of the Research Diagnostic Criteria for Temporomandibular Disorders: Overview and Methodology. J Orofac Pain. 2009 in revision. - PMC - PubMed
    1. Ahmad M, Hollender L, Anderson Q, Kartha K, Ohrbach R, Truelove E, Mike JT, Schiffman E. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD): Development of Image Analysis Criteria and Examiner Reliability for Image Analysis. Accepted for publication. - PMC - PubMed

    1. http://roadrunner.cancer.med.umich.edu/comp/docs/R.rpart.pdf.

Publication types

MeSH terms

LinkOut - more resources