RESEARCH DIAGNOSTIC CRITERIA-- RELIABILITY AND VALIDITY

描述：（改编自申请人的摘要）：颞下颌 疾病（TMD）是普通人群的常见问题。研究 TMD 诊断标准 (RDC) 的制定是为了建立具体的 8 轴 I 的操作化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。 RDC 已建立程序可靠性测试 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、普遍性和临床实用性 检查项目、生物医学诊断、生物行为评估、 通用协议。为了实现这些总体目标，多中心 提议的项目将首先在明尼苏达大学重新评估 6 名审查员的可靠性（3 所参与大学各 2 名审查员） 使用 RDC 操作收集临床 Axis I 检查数据 定义。第二步，可靠的盲检人员将收集临床数据 检查数据并制定 RDC 诊断，并将其与 由专家影像学做出的标准诊断。新的临床检查项目将 也进行评估。根据专家共识，它们将被添加以产生 期末考试协议将包括所有当前 RDC 考试项目 作为新项目。通过这个新协议，6 位审查员将继续 在各自的中心检查正常人和 TMD 受试者以进行测试 新的和现有的时间稳定性和诊断有效性 检查项目、患者病史项目以及平片和 TMJ 成像 核磁共振成像。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 活组织检查和颞下颌关节滑液将从受试者身上收集 明尼苏达大学评估生物标志物的作用 生物医学诊断的潜在介质。同时，轴 II 生物行为评估程序将测试时间可靠性， 与其他公认的同时有效的自我报告工具相比， 并在两个中心针对高度结构化的标准有效性进行了评估 精神病学访谈。添加 Axis 的临床和健康服务效用 II 生物行为评估、成像和活检结果至 Axis I 临床 将对检查结果进行评估。我们对事物理解的进步 TMD 的患病率、病因、自然进展和治疗取决于 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.