VALIDITY OF DIAGNOSTIC AND MONITORING TESTS USED FOR TEMPOROMANDIBULAR DISORDERS

Currently, diagnosis of temporomandibular disorders (TMD) depends on a comprehensive history and physical examination, supplemented, when in dicated, by images of hard and soft tissues. However, there are electr onic diagnostic devices being marketed to acquire other measures descr ibed as relevant to TMD and to use these for diagnosis of TMD and for monitoring the effects of treatment. This paper reviews the capacity o f several devices to measure these variables accurately and reliably a nd to assess the theoretical basis of each of these tests. Diagnostic ability was established, when possible, according to the commonly acce pted measures of sensitivity, specificity, and positive predictive val ues. It was found that many tests lack theoretical validity, that meas urement validity tends to be poor, and that diagnostic ability can be even worse than chance, because of a high percentage of false-positive diagnoses. Based on these findings, the use of these instruments in c linical practice is inappropriate at this time and may lead to the tre atment of large numbers of subjects who have no disorder.