RESEARCH DIAGNOSTIC CRITERIA-- RELIABILITY AND VALIDITY

描述：(改编自申请者？S摘要)：颞颌 障碍(TMD)是普通人群中的常见问题。研究报告 开发了TMD的诊断标准(RDC)以建立特定的 8轴I的可操作性检查程序和诊断标准 TMD的生物医学诊断以及Axis II生物行为评估 程序。已经为RDC建立了程序可靠性测试 AXIS I检查项目，但完全接受RDC需要确认 的时间稳定性、有效性、可推广性和临床实用性 检查项目、生物医学诊断、生物行为评估和 通用协议。为了实现这些总体目标，多中心 该项目将首先在明尼苏达大学重新评估 6名主考员的可靠性(3所参与大学各2名主考员) 使用RDC操作收集临床Axis I检查数据 定义。在第二步，可靠的盲检人员将收集临床数据 检查数据和制定RDC诊断，并将其与 由影像专家做出的标准诊断。新的临床考试项目将 也要接受评估。根据专家的共识，它们将被添加到一起，以产生一个 期末考试协议也将包括所有当前的RDC考试项目 作为新的项目。有了这个新的协议，6名主考者将继续 在各自的中心检查正常受试者和TMD受试者以进行测试 新的和现有的诊断方法的时间稳定性和诊断有效性 检查项目、病史项目和TMJ平片和 核磁共振检查。将使用判别分析和决策树分析来确定 用于呈现RDC诊断的最佳诊断算法。咀嚼肌 受试者的活检和关节滑液将在 明尼苏达大学评估生物标记物作为 潜在的生物医学诊断的介体。同时，轴 II生物行为评估程序将进行时间可靠性测试， 与其他被接受的同时有效性的自我报告工具相比， 在两个中心，对高度结构化的标准有效性进行了评估 精神科面谈。增加Axis的临床和卫生服务效用 II对Axis I临床的生物行为评估、成像和活检结果 将对考试结果进行评估。我们对这一问题的理解有了进展 TMD的患病率、病因、自然进展和治疗是相关的 对这些疾病有可靠和有效的诊断标准。

DESCRIPTION: (adapted from the applicant?s abstract): Temporomandibular disorders (TMD) are common problems in the general population. The Research Diagnostic Criteria (RDC) for TMD were developed to establish specific operationalized examination procedures and diagnostic criteria for 8 Axis I biomedical diagnoses of TMD, as well as Axis II biobehavioral assessment procedures. Procedural reliability testing has been established for the RDC Axis I examination items, but full acceptance of the RDC requires confirmation of the temporal stability, validity, generalizability and clinical utility of the examination items, biomedical diagnoses, biobehavioral assessments, and general protocol. In order to accomplish these overall goals, a multi-center project is proposed that will first reassess at the University of Minnesota the reliability of 6 examiners (2 examiners each from 3 participating universities) to collect clinical Axis I examination data using the RDC operational definitions. In a second step, reliable blinded examiners will collect clinical examination data and formulate RDC diagnoses, which will be compared to criterion diagnoses made by an expert imaging. New clinical exam items will also be assessed. Subject to expert consensus, they will be added to yield a final exam protocol that will include all current RDC examination items as well as the new items. With this new protocol, the 6 examiners will continue examining normal and TMD subjects at their respective centers in order to test the temporal stability and diagnostic validity of the new and existing examination items, patient history items, and TMJ imaging by plain film and MRI. Discriminant analyses and decision tree analyses will be used to determine the best diagnostic algorithms for rendering RDC diagnoses. Masticatory muscle biopsies and TMJ synovial fluid will be collected from subjects at the University of Minnesota to evaluate biological markers for their role as potential mediators underlying the biomedical diagnoses. Simultaneously, Axis II biobehavioral assessment procedures will be tested for temporal reliability, compared with other accepted self-report instruments for concurrent validity, and, at two centers, evaluated for criterion validity against highly structured psychiatric interviews. The clinical and health services utility of adding Axis II biobehavioral assessments, imaging and biopsy results to Axis I clinical examination findings will be appraised. Advancement in our understanding of the prevalence, etiologies, natural progression, and treatment of TMD is dependent on having reliable and valid diagnostic criteria for these disorders.