Reliability and Validity of the DC/TMD Axis I

we appreciate the opportunity to comment on the Focus Article by Drs Steenks, Türp, and de Wijer.1 We have focused our com-ments on their most significant points regarding the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD).2 First, we will summarize the principles used when developing the DC/TMD Axis I algorithms3:

• Include parts of the Research Diagnostic Criteria for TMD (RDC/TMD) when indicated

• Keep the DC/TMD Axis I as simple as possible so clinicians and researchers will use it

• Use well-operationalized, reliable tests

• Use case definitions, derived by consensus from experts in TMD and allied fields, to determine which tests to include or exclude from the Revised RDC/TMD Axis I diagnostic algorithms

• Test these case definitions for diagnostic accuracy using the reference standards from the Validation Project

1.Steenks MH, Türp JC, de Wijer A. Reliability and validity of the Diagnostic Criteria for Temporomandibular Disorders Axis I in clinical and research settings: A critical appraisal. J Oral Facial Pain Headache 2018;32:7–18.

2.Schiffman E, Ohrbach R, Truelove E, et al. Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research ap-plications: Recommendations of the International RDC/TMD Consortium Network and Orofacial Pain Special Interest Group. J Oral Facial Pain Headache 2014;28:6–27.

3.Schiffman EL, Truelove EL, Ohrbach R, et al. The Research Diagnostic Criteria for Temporomandibular Disorders. I: Overview and methodology for assessment of validity. J Orofac Pain 2010;24:7–24.

4.Peck CC, Goulet JP, Lobbezoo F. Expanding the taxonomy of the Diagnostic Criteria for Temporomandibular Disorders. J Oral Rehabil 2014;41:2–23.

5.Bossuyt PM, Reitsma JB, Bruns DE, et al. Towards complete and accu-rate reporting of studies of diagnostic accuracy: The STARD initiative. Standards for Reporting of Diagnostic Accuracy. Clin Chem 2003;49:1–6.

6.Svensson P, Michelotti A, Lobbezoo F, List T. The many faces of persistent orofacial muscle pain. J Oral Facial Pain Headache 2015;29:207–208.

7.Varun S et al. Cross-sectional study on the association between mas-ticatory muscle pain diagnoses and biopsychosocial factors [poster]. Scottsdale: American Academy of Orofacial Pain, 2017.

8.International Headache Society Classification ICHD-3 Beta. https://www.ichd-3.org.