The Diagnostic Validity of Clinical Tests in Temporomandibular Internal Derangement: A Systematic Review and Meta-analysis.
Purpose: To assess the diagnostic validity of clinical tests for temporomandibular internal derangement relative to magnetic resonance imaging (MRI). Methods: MEDLINE and Embase were searched from 1994 through 2009. Independent reviewers conducted study selection; risk of bias was assessed using Qua...
| Publicado en: | Physiotherapy Canada Vol. 64; no. 2; pp. 116 - 135 |
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| Autores principales: | , , , |
| Formato: | research systematic review tables/charts Journal Article |
| Publicado: |
University of Toronto Press
2012
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104546226&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104546226 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 03000508 R42 jtl: Physiotherapy Canada issn: 03000508 maglogo: N pubinfo: dt: 2012 vid: 64 iid: 2 pid: 678 pub: University of Toronto Press place: North York, Ontario artinfo: ui: 104546226 74078363 2011508712 10.3138/ptc.2010-54 NLM23449757 PMC3321987 104546226 ppf: 116 ppct: 19 formats: fmt: @attributes: type: P tig: atl: The Diagnostic Validity of Clinical Tests in Temporomandibular Internal Derangement: A Systematic Review and Meta-analysis. aug: au: Chaput, Eve Stewart, Ryan Nadeau, Gordon Goldsmith, Charlie H. affil: A1 sug: subj: Temporomandibular Joint Diseases Diagnosis Adolescence Adult Aged Confidence Intervals Descriptive Statistics Female Human kappa Statistic Male Meta Analysis Middle Age P-Value Predictive Value of Tests Sensitivity and Specificity Systematic Review Adolescent: 13-18 years Adult: 19-44 years Aged: 65+ years Middle Aged: 45-64 years Female Male ab: Purpose: To assess the diagnostic validity of clinical tests for temporomandibular internal derangement relative to magnetic resonance imaging (MRI). Methods: MEDLINE and Embase were searched from 1994 through 2009. Independent reviewers conducted study selection; risk of bias was assessed using Quality Assessment of studies of Diagnostic Accuracy included in Systematic reviews (QUADAS); b9/14) and data abstraction. Overall quality of evidence was profiled using Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Agreement was measured using quadratic weighted kappa (kw). Positive (+) or negative (-) likelihood ratios (LR) with 95% CIs were calculated and pooled using the DerSimonian-Laird method and a random-effects model when homogeneous (I² >/= 0.40, Q-test p </= 0.10). Results: We selected 8 of 36 studies identified. There is very low quality evidence that deflection (+LR: 6.37 [95% CI, 2.13-19.03]) and crepitation (LR:5.88 [95% CI, 1.95-17.76]) as single tests and crepitation, deflection, pain, and limited mouth opening as a cluster of tests are the most valuable for ruling in internal derangement without reduction (+LR:6.37 [95% CI, 2.13-19.03]), (-LR:0.27 [95% CI, 0.11-0.64]) while the test cluster click, deviation, and pain rules out internal derangement with reduction (-LR: 0.09 [95% CI, 0.01-0.72]). No single test or cluster of tests was conclusive and of significant value for ruling in internal derangement with reduction. Conclusions: Findings of this review will assist clinicians in deciding which diagnostic tests to use when internal derangement is suspected. The literature search revealed a lack of high-quality studies; further research with adequate description of patient populations, blinded assessments, and both sagittal and coronal MRI planes is therefore recommended. pubtype: Academic Journal doctype: meta analysis research systematic review tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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