Agreement between screening interview and gold standard diagnosis in TMD

Materials and Methods: A standardized phone-screening interview by trained lay interviewers was given to 134 subjects recruited for a diagnosis study. The interview, comprised of 26 items assessing present pain, jaw mobility and joint sounds during the prior month, resulted in a screening diagnosis. Two independent clinical examinations and an imaging evaluation (MRI and CT scans) provided by trained and calibrated examiners and radiologists, produced the gold standard diagnoses for each subject.

Results: In this study 85% of the subjects were female with a mean age of 40.8 ±11.7 years. Based on the screening interview the frequency of symptoms were reported as follows: 87% masticatory pain, 90% joint pain, 89% clicking noises, 60% crepitus, and 49% inability to open their mouth as well as they could previously.

The sensitivity and specificity of self-reported symptoms from the screening interview were respectively: muscle pain: (91%, 64%) joint pain: (96%, 22%), clicking: (71%, 92%), crepitus: (75%, 42%) and history of locking (14%, 93%)

The sensitivity and specificity for predicting gold standard diagnoses from screening diagnoses were respectively: myofascial pain: (68%, 91%), disk displacement with reduction: (91%, 8%), disk displacement without reduction (71%, 55%) and for osteoarthritic conditions: (86%, 30%).

Conclusion: The current analysis demonstrates that screening interviews may provide useful information at the symptom level to discriminate among either true positive or true negative. Similarly, none of the screening diagnoses had acceptable levels of both sensitivity and specificity to predict gold standard diagnoses.

This study is supported by NIDCR Grant # UO1-DEO13331