Research diagnostic criteria for temporomandibular disorders: a calibration and reliability study

Cranio. 2005 Jul;23(3):212-8. doi: 10.1179/crn.2005.030.

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).

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Validation Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Calibration
  • Female
  • Humans
  • Joint Dislocations / diagnosis
  • Male
  • Mandible / physiopathology
  • Masseter Muscle / physiopathology
  • Middle Aged
  • Observer Variation
  • Palpation / methods
  • Pterygoid Muscles / physiopathology
  • Range of Motion, Articular / physiology
  • Reproducibility of Results
  • Single-Blind Method
  • Sound
  • Temporal Muscle / physiopathology
  • Temporomandibular Joint / physiopathology
  • Temporomandibular Joint Disc / physiopathology
  • Temporomandibular Joint Disorders / diagnosis*
  • Temporomandibular Joint Dysfunction Syndrome / diagnosis