title: Research diagnostic criteria for temporomandibular disorders: a calibration and reliability study.
abstract: The aim of this study was to investigate the reliability between different examiners when using the axis I of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). The hypothesis was that the standardized RDC/TMD examination protocol enables calibrated examiners to evaluate all examination items reliably. After calibration training by the RDC/TMD calibration team including the calibration of palpation pressure and the performance of the standardized examination protocol, four examiners, blinded to the patients' medical histories examined 24 subjects in a randomized sequence. One experienced examiner was the standard (hierarchical calibration). The recorded measurements strictly followed the RDC/TMD. Intraclass correlation coefficients (ICC), bias and precision were calculated to estimate interrater reliability. Acceptable (0.75 > or = CC > 0.4) to excellent (ICC > 0.75) reliability was found for 20 of the 23 (87%) examinations. Only sub-retromandibular muscle palpation and joint sound vibration recordings on lateral excursion showed poor-results (ICC < or = 0.4). The RDC/TMD examination protocol enables calibrated examiners to perform most (87%) examination items with satisfactory reliability. Therefore multi-site studies based on the RDC/TMD examination protocol may become feasible, keeping in mind the unsatisfactory reliability of 13% of the items (clicking during laterotrusion to the ipsilateral side, palpation of the posterior and submandibular region).
authors.affiliation: University of Heidelberg, Dept. of Prosthodontics, Im Neuenheimer Feld 400, D-69120 Heidelberg, Germany. Marc_Schmitter@med.uni-heidelberg.de
authors.forename: Marc
authors.initials: M
authors.lastname: Schmitter
authors.forename: Brigitte
authors.initials: B
authors.lastname: Ohlmann
authors.forename: Mike T
authors.initials: MT
authors.lastname: John
authors.forename: Christian
authors.initials: C
authors.lastname: Hirsch
authors.forename: Peter
authors.initials: P
authors.lastname: Rammelsberg
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002138:Calibration; D005260:Female; D006801:Humans; D004204:Joint Dislocations / Q000175:diagnosis; D008297:Male; D008334:Mandible / Q000503:physiopathology; D008406:Masseter Muscle / Q000503:physiopathology; D008875:Middle Aged; D015588:Observer Variation; D010173:Palpation / Q000379:methods; D011626:Pterygoid Muscles / Q000503:physiopathology; D016059:Range of Motion, Articular / Q000502:physiology; D015203:Reproducibility of Results; D016037:Single-Blind Method; D013016:Sound; D013703:Temporal Muscle / Q000503:physiopathology; D013704:Temporomandibular Joint / Q000503:physiopathology; D019224:Temporomandibular Joint Disc / Q000503:physiopathology; D013705:Temporomandibular Joint Disorders / Q000175:diagnosis*; D013706:Temporomandibular Joint Dysfunction Syndrome / Q000175:diagnosis