Consistência interna e reprodutibilidade da versão em português do critério de diagnóstico na pesquisa para desordens temporomandibulares (RDC/TMD - Eixo II)

Abstract

AbstrActobjective: To study the reliability of the portuguese version of a questionnaire for psychologically and psychosocially diagnosing individuals with temporomandibular disorders (RDC/TMD). Method: Interviews were held with 109 individuals of both sexes who required care at the physical therapy clinic of the Araraquara university Center (uNIARA) from January to July 2006. The questionnaires were applied by a single examiner. Two weeks later, the same questionnaire was reapplied to 36 individuals. To evaluate the internal consistency of the method, Cronbach's alpha coefficient was used. The intra-examiner reproducibility was analyzed using the intraclass correlation coefficient (ρ) for quantitative variables and Kappa (κ) statistics for qualitative variables. Results: The internal consistency for the dimensions of chronic pain intensity, disability, limitations relating to mandibular function, nonspecific physical symptoms with pain items included, and nonspecific physical symptoms with pain items and depression excluded, were 0.8479, 0.8971, 0.8673, 0.8080 and 0.9270 respectively, thus confirming the excellent internal validity of the method. The intra-observer agreement was found to be "excellent" for questions relating to pain duration and intensity and "good" for the question relating to current pain. The lowest κ values were associated with items relating to physical symptoms and depression. The subjects' perception of clicking and creaking also had "satisfactory" agreement, as did the question on seeking professionals for pain treatment. The remaining questions showed "good" and "very good" reproducibility and most of them presented the maximum agreement. Conclusion: The portuguese adaptation of the questionnaire was shown to be reliable for detecting psychological and psychosocial abnormalities relating to temporomandibular disorders. ) e a estatística Kappa (κ), respectivamente às variáveis de natureza quantitativa e qualitativa. Resultados: A consistência interna para as dimensões intensidade da dor crônica e incapacidade; limitação da função mandibular; sintomas físicos não-específicos, incluindo os itens de dor; sintomas físicos não-específicos, excluindo os itens de dor e depressão foi de 0,8479, 0,8971, 0,8673, 0,8080 e 0,9270 respectivamente, atestando ao método excelente validade interna. obteve-se "excelente" concordância intra-examinador para as questões referentes ao tempo de presença da dor e sua gradação, e "boa" para a questão referente à dor presente. Os menores valores de κ relacionaram-se aos itens de sintomas físicos e depressão. A percepção de estalos ou rangidos pelos indivíduos apresentou concordância "regular" bem como a questão referente à procura de profissional para tratamento da dor. As demais questões apresentaram reprodutibilidade "boa" e "ótima", sendo que a maioria dessas apresentou nível máximo de concordância. Conclusão: A versão adaptada para o português mostrou-se confiável para detecção das alterações psicológicas e psicossociais associadas às desordens temporomandib...

Confiabilidade de um formulário para diagnóstico da severidade da disfunção temporomandibular

“…Considering that epidemiological and clinical TMD studies are subject to several errors associated mainly with methodological aspects 7,30 , it is very important to evaluate the internal consistency and the reproducibility of instruments in order to make a correct TMD diagnosis. Therefore, it is suggested that the questionnaire proposed by Da Fonseca et al 2 should not be discarded as it possesses useful characteristics for epidemiological studies such as simplicity, speed, low cost and the possibility of data collection over the telephone.…”

“…The results of these studies vary considerably due to the different methodologies applied, to the characteristics of the populations and to the data collection [1][2][3][4][5][6][7] . According to several studies published in different countries, TMD has shown a high prevalence in the populations 2,[8][9][10][11] .…”

Assessment of cross-cultural adaptations and measurement properties of self-report outcome measures in Portuguese relevant to temporomandibular disorders: a systematic review

“…Two articles and one book chapter ( Figure 1) were included by manual search, totaling nine eligible studies. Four different instruments were translated/adapted into Portuguese, namely: Research Diagnostic Criteria for Temporomandibular Disorders: Axis II (RDC/TMD) [11][12][13][14] , Questionnaire and Anamnesic Index of Fonseca 5,15 , Questionnaire of the American Academy of Orofacial Pain (QAAOP) 2,16 and Mandibular Function Impairment Questionnaire (MFIQ) 17 (Table 1). Among the nine studies analyzed, four translated and/or adapted an instrument.…”

“…In this review, it was possible to identify that most that most of the questionnaires had their concordance assessed, and only two of them 12,13 showed adequate results, however, both of them assessed the RDC/TMD (Table 2). Two different studies have also examined the concordance: one assessed the QAAOP 16 ; the other, the Questionnaire and Anamnesic Index of Fonseca 5 , but had minimally important change within the limits of concordance.…”

“…The internal consistency was assessed on the RDC/ TMD 12,13 and the MFIQ 17 , through the Cronbach's alpha, with results considered positive. Another study which evaluated the internal consistency of the RDC/ TMD 14 has obtained a Cronbach's alpha ranging from 0.68 to 0.73, which was not considered to be appropriate.…”