title: Diagnostic accuracy of temporomandibular disorder pain tests: a multicenter study.
abstract: OBJECTIVE
  To estimate the diagnostic accuracy of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) clinical examination and of the dynamic/static tests for the recognition of TMD pain. Since the diagnosis of TMD pain is especially complicated in persistent orofacial pain patients, the test outcomes in persistent TMD pain patients were contrasted to those in two control groups: a group of persistent dental pain patients and a group of pain-free subjects.
  
  
  METHODS
  In 125 persistent TMD pain patients, 88 persistent dental pain patients, and 121 pain-free subjects, a blind and standardized clinical examination was performed.
  
  
  RESULTS
  For the RDC/TMD, sensitivity (88%) was high and specificity was low (pain-free group: 71%; dental pain group: 45%). For the dynamic/static tests, sensitivity was 65% and specificities were 91% and 84%, respectively. Comparing the outcomes of the two examinations showed higher positive likelihood ratios for dynamic/static tests (P < .001), and lower negative likelihood ratios for the RDC/TMD examination (P < .01).
  
  
  CONCLUSIONS
  For the confirmation of a suspicion of TMD pain, it is better to rely on positive dynamic/static tests. To confirm the absence of TMD pain, it is better to rely on a negative RDC/TMD examination.
authors.affiliation: Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam, Louwesweg 1, 1066 EA Amsterdam, The Netherlands. c.visscher@acta.nl
authors.forename: Corine M
authors.initials: CM
authors.lastname: Visscher
authors.forename: Machiel
authors.initials: M
authors.lastname: Naeije
authors.forename: Antoon
authors.initials: A
authors.lastname: De Laat
authors.forename: Ambra
authors.initials: A
authors.lastname: Michelotti
authors.forename: Maria
authors.initials: M
authors.lastname: Nilner
authors.forename: Bart
authors.initials: B
authors.lastname: Craane
authors.forename: EwaCarin
authors.initials: E
authors.lastname: Ekberg
authors.forename: Mauro
authors.initials: M
authors.lastname: Farella
authors.forename: Frank
authors.initials: F
authors.lastname: Lobbezoo
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005157:Facial Pain / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006801:Humans; D016013:Likelihood Functions; D016015:Logistic Models; D008297:Male; D010147:Pain Measurement; D010173:Palpation; D012680:Sensitivity and Specificity; D016037:Single-Blind Method; D013705:Temporomandibular Joint Disorders / Q000150:complications / Q000175:diagnosis*; D014098:Toothache / Q000175:diagnosis