Translation and Adaptation of the Diagnostic Criteria for Temporomandibular Disorders into the Malay Language: Psychometric Evaluation of Contents

Aims: To develop the Malay DC/TMD through a formal cross-cultural adaptation (CCA) process for use in non–English speaking populations and to determine the reliability and validity of the Malay Graded Chronic Pain Scale (M-GCPS) and Malay Jaw Functional Limitation Scale (M-JFLS). Methods: The English DC/TMD was translated into the Malay language using the forward-backward translation procedures specified in the INfORM guideline. The initial Malay instrument was pre-tested, and any discrepancies were identified and reconciled before producing the final Malay DC/TMD. Psychometric properties of the M-GCPS and M-JFLS were evaluated using a convenience sample of 252 subjects and were assessed using internal consistency and test-retest reliability, as well as face, content, concurrent, and construct validity testing. Internal consistency was assessed using Cronbach’s alpha, while test-retest reliability was examined using intraclass correlation coefficient (ICC). Concurrent and construct validity of both domains were performed using Spearman ρ correlation test. In addition, construct and discriminant validity were appraised using Kruskal-Wallis and Mann-Whitney U tests, respectively. Results: Cronbach’s alpha values for the M-GCPS and M-JFLS were 0.95 and 0.97, respectively. The ICC was 0.98 for the M-GCPS and 0.99 for M-JFLS. The majority of the tested associations for both domains were found to be statistically significant, with good positive correlations. Conclusion: The M-GCPS and M-JFLS were found to be reproducible and valid. The Malay DC/TMD shows potential for use among Malay-speaking adults.

cross-cultural adaptation; DC/TMD; Malay language; temporomandibular disorders; translation

1. Yap AU, Dworkin S, Chua EK, List T, Tan KBC, Tan HH. Prevalence of temporomandibular subtypes, psychological distress and psychosocial dysfunction in Asian patients. J Orofac Pain 2003;17:21–28.

2. Dahlström L, Carlsson GE. Temporomandibular disorders and oral health-related quality of life. A systematic review. Acta Odontol Scand 2010;68:80–85.

3. Slade GD, Fillingim RB, Sanders AE, et al. Summary of findings from the OPPERA prospective cohort study of incidence of first-onset temporomandibular disorder: Implications and future directions. J Pain 2013;14:116–124.

4. Schiffman E, Ohrbach R, Truelove E, et al. Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for clinical and research applications: Recommendations of the international RDC/TMD consortium network and orofacial pain special interest group. Oral Facial Pain Headache 2014;28:6–27.

5. Dworkin S, LeResche L. Research diagnostic criteria for temporomandibular disorders: Review, criteria, examinations and specifications, critique. J Craniomandib Disord 1992;69:301–355.

6. Epstein J, Santo RM, Guillemin F. A review of guidelines for cross-cultural adaptation of questionnaires could not bring out a consensus. J Clin Epidemiol 2015;68:435–441.

7. International Network for Orofacial Pain and Related Disorders Methodology, 2017. https://ubwp.buffalo.edu/rdc-tmdinterna-tional/. Accessed June 18, 2020.

8. Floyd FJ, Widaman KF. Factor analysis in the development and refinement of clinical assessment instruments. Psychol Assess 1995;7:286–299.

9. He SL, Wang JH, Wang MH, Deng YM. Validation of the Chinese version of the halitosis associated life-quality test (HALT) questionnaire. Oral Dis 2012;18:707–712.

10. He SL, Wang JH. Reliability and validity of a Chinese version of the oral health impact profile for edentulous subjects. QualLife Res 2015;24:1011–1016.

11. Hashim AN, Yusof ZY, Esa R. The Malay version of the Early Childhood Oral Health Impact Scale (Malay-ECOHIS) -- assessing validity and reliability. Health Qual Life Outcomes 2015;13:190.

12. Bland JM, Altman DG. Cronbach’s alpha. BMJ 1997;314:572.

13. Aisyaturridha A, Naing L, Nizar AJ. Validation of the Malay brief pain inventory questionnaire to measure cancer pain. Symptom Manage 2016;31:13–21.

14. Saub R, Locker D, Allison P, Disman M. Cross-cultural adaptation of the oral health impact profile (OHIP) for the Malaysian adult population. Community Dent Health 2007;24:166–175.

15. Feise RJ, Menke JM. Functional rating index: A new valid and reliable instrument to measure the magnitude of clinical change in spinal conditions. Spine Phila Pa 2001;26:78–87. Erratum in: Spine 2001;26:596.

16. Altman DG. Practical Statistics for Medical Research. London: Chapman and Hall, 1991.

17. John MT, Hirsch C, Reiber T, Dworkin SF. Translating the research diagnostic criteria for temporomandibular disorders into German: Evaluation of content and process. J Orofac Pain 2006;20:43–52.

18. Ohrbach R. Translation and adaptation of the DC/TMD protocol. International Network for Orofacial Pain and Related Disorders Methodology. Revised 29 September 2017. https://buffalo.app.box.com/s/fugxw2tt9iz4zf5j9lygvfyvdj2fzrhx. Accessed 1 October 2020.

19. Ohrbach R, Bjorner J, Jezewski MA, John MT, Lobbezoo F. Guidelines for establishing cultural equivalency of instruments. International Network for Orofacial Pain and Related Disorders Methodology. Updated 11 May 2013. https://ubwp.buffalo.edu/rdc-tmdinternational/wp-content/uploads/sites/58/2017/01/Guidelines-for-Translation-and-Cultural-Equivalency-of-Instruments-2013_05_118608.pdf. Accessed 1 October 2020.

20. Khoo SP, Yap AU, Chan YH, Bulgiba AM. Translating the research diagnostic criteria for temporomandibular disorders intoMalay: Evaluation of content and process. J Orofac Pain 2008;22:131–138.

21. Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the process of cross-cultural adaptation of self report measures. Spine 2000;25:3186–3191.

22. de Lucena LB, Kosminsky M, da Costa LJ, de Góes PS. Validation of the Portuguese version of the RDC/TMD axis II questionnaire. Braz Oral Res 2006;20:312–317.

23. Vetter TR, Schober P. Agreement analysis: What he said, she said versus you said. Anesth Analg 2018;126:2123–2128.

24. Terwee CB, Bot SD, de Boer MR, et al. Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol 2007;60:34–42.

25. Souza AC, Alexandre NMC, Guirardello EB. Psychometric properties in instruments evaluation of reliability and validity. Epidemiol Serv Saude 2017;26:649–659.