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Clinical Oral Investigations
Published in: Clinical Oral Investigations 8/2013

01-11-2013 | Original Article

Insufficient diagnostic accuracy of a single-item questionnaire to detect psychosocial distress in temporomandibular disorder patients

Authors: Daniel R. Reissmann, Mike T. John, Levente Kriston, Oliver Schierz

Published in: Clinical Oral Investigations | Issue 8/2013

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Abstract

Objectives

Psychosocial assessment needs to be integrated into the diagnosis of chronic pain conditions; however, it is not clear how this assessment should be performed with minimal patient and health care provider burden. The aim of this study was to assess the diagnostic accuracy of a single-item questionnaire to detect psychosocial distress in temporomandibular disorder (TMD) patients.

Methods

Presence of psychosocial distress was measured in 126 TMD patients using Research Diagnostic Criteria for TMD Axis II measures (depression, somatization, dysfunctional chronic pain). A newly developed single-item questionnaire served as a test to detect psychosocial distress. The association between the presence of distress and test results was analyzed using generalized linear models (GLM). Diagnostic accuracy of the one-item test was assessed.

Results

The GLM revealed a statistically significant association between the presence of psychosocial distress and a positive test result (p < 0.001). Psychosocially distressed patients were 70 % more likely to indicate psychosocial distress in the single-item questionnaire than patients without distress. However, diagnostic test accuracy of the single-item questionnaire was low (sensitivity 73.0 %, specificity 55.7 %). The resulting positive likelihood ratio (1.65) indicated that the single-item test is an inadequate measure for detecting psychosocial distress.

Conclusions

The single-item questionnaire was not sufficiently accurate for detecting TMD patients’ psychosocial distress and may therefore not be useful as an assessment tool for the various dimensions of psychosocial distress in TMD patients.

Clinical relevance

Health care providers should not trust in TMD patients’ responses to a single question regarding psychosocial distress. Nevertheless, this questionnaire may constitute a first step into a more profound patient–provider communication on psychological issues relevant to TMD.
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Metadata
Title
Insufficient diagnostic accuracy of a single-item questionnaire to detect psychosocial distress in temporomandibular disorder patients
Authors
Daniel R. Reissmann
Mike T. John
Levente Kriston
Oliver Schierz
Publication date
01-11-2013
Publisher
Springer Berlin Heidelberg
Published in
Clinical Oral Investigations / Issue 8/2013
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI
https://doi.org/10.1007/s00784-012-0892-0

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