颞下颌关节紊乱病简易诊断标准：临床诊断的敏感性和特异性（一项多中心研究）
Brief Diagnostic Criteria for Temporomandibular Disorders: Sensitivity and Specificity of Clinical Diagnoses (A Multi-Center Study).
作者信息
Nykänen Laura, Sipilä Kirsi, Eli Ilana, Freidman-Rubin Pessia, Keren Lihi, Kämppi Antti, Näpänkangas Ritva, Tamar Shalev Antshel, Tanner Johanna, Teerijoki-Oksa Tuija, Winocur Ephraim, Emodi-Perlman Alona
机构信息
Department of Oral and Maxillofacial Diseases, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
Clinic of Oral and Maxillofacial Diseases, Head and Neck Center, Helsinki University Central Hospital, Helsinki, Finland.
出版信息
J Oral Rehabil. 2025 Aug;52(8):1251-1258. doi: 10.1111/joor.13969. Epub 2025 Apr 7.
BACKGROUND
The brief Diagnostic Criteria for Temporomandibular Disorders (bDC/TMD) was recently published to simplify the full Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) protocol.
OBJECTIVE
To measure the inter-examiner reliability, sensitivity and specificity of bDC/TMD Axis I diagnoses against DC/TMD Axis I diagnoses in primary and tertiary clinic TMD patient populations.
METHODS
A multi-center (Finland, Israel) retrospective study on 334 patients' records was conducted. A full DC/TMD clinical examination data was reduced to bDC/TMD items. Five Level 3 calibrated examiners independently determined a bDC/TMD diagnosis. Inter-examiner reliability, sensitivity and specificity were calculated for individual diagnoses, using DC/TMD diagnosis as the reference standard.
RESULTS
Inter-examiner reliability showed excellent to good reliability in all diagnoses except headache attributed to TMD, in which it was fair. Apart from headache attributed to TMD, the sensitivity of individual pain diagnoses was high. The sensitivity was lower in joint diagnoses. The specificity was high in all diagnoses.
CONCLUSION
The bDC/TMD is a reliable instrument for general practitioner use.
背景
颞下颌关节紊乱病简易诊断标准（bDC/TMD）最近已发布，以简化完整的颞下颌关节紊乱病诊断标准（DC/TMD）方案。
目的
在初级和三级诊所的颞下颌关节紊乱病患者群体中，针对DC/TMD轴I诊断，测量bDC/TMD轴I诊断的检查者间可靠性、敏感性和特异性。
方法
对334例患者的记录进行了一项多中心（芬兰、以色列）回顾性研究。完整的DC/TMD临床检查数据被简化为bDC/TMD项目。5名经过三级校准的检查者独立确定bDC/TMD诊断。以DC/TMD诊断为参考标准，计算个体诊断的检查者间可靠性、敏感性和特异性。
结果
除了归因于颞下颌关节紊乱病的头痛诊断检查者间可靠性为中等外，所有诊断的检查者间可靠性均显示为优或良。除了归因于颞下颌关节紊乱病的头痛外，个体疼痛诊断的敏感性较高。关节诊断的敏感性较低。所有诊断的特异性均较高。
结论
bDC/TMD是一种可供全科医生使用的可靠工具。
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