Development of a brief and effective temporomandibular disorder pain screening questionnaire Reliability and validity

Background. Available screening instruments for identifying temporomandibular disorders (TMDs) exhibit methodological or logistic limitations. The authors conducted a study to develop and assess the validity of a self-report instrument in screening patients for pain-related TMDs. Methods. By using psychometric methods for item selection, the authors developed short (three-item) and long (six-item) versions of the questionnaire and evaluated them for validity among 504 participants. Results. Internal reliability was excellent, with coefficient a values of 0.87 and 0.93 for the short and long versions, respectively. When the authors dichotomized instrument scores at optimal thresholds, both versions had a sensitivity of 99 percent and a specificity of 97 percent for correct classification of the presence or absence of TMD. The specificity was at least 95 percent in the correct identification of people with nonpainful TMJ disorders or headahce without TMD pain. Conclusions. With use of appropriate psychometric methodology, the selected items exhibited excellent content validity. The excellent levels of reliability, sensitivity and specificity demonstrate the validity and usefulness of this instrument. Clinical Implications. Using this instrument will allow clinicians to identify more readily and cost-effectively most patients with painful TMD conditions for whom early and reliable identification would have a significant effect on diagnosis, treatment and prognosis.