About This Section

This section contains information to allow calibration, training and reliability assessment of RDC/TMD Axis I and Axis II examiners.  Material includes includes rationale and protocols for each stage of calibration, training and conducting a reliability study. 

Assessment of clinical reliability is the generally accepted method for maximizing the likelihood that all RDC/TMD examiners would come up with the same clinical observations, no matter where or when they conduct RDC/TMD clinical examinations.

Note: Examiner in Training (EXT) for conducting  RDC/TMD Axis I and Axis II clinical  examinations may include DDS, RDH, RN and other clinic staff.

Items listed with an * asterisk in each "Materials and Subjects" section need to be provided by Study Site.

Overview

The following training, calibration and reliability assessment procedures are recommended for standardizing all clinicians in the conduct of the Axis I Clinical Examination for Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD ).

These training procedures have been in effect at the University of Washington Orofacial Pain and Disorders Clinic and Research Group prior to formal incorporation of the RDC/TMD into clinical research protocols in 1992.  The University Of Washington Research Group has two Axis I Gold Standard Examiners (GSE), Dr. Edmond Truelove, DDS, MSD and Kimberly H. Huggins RDH,BS, who can train and calibrate other clinical examiners to become reliable in the conduct of the RDC/TMD Axis I examination and diagnosis methods.

Training in administering, scoring and interpreting RDC/TMD Axis II measures of jaw function, psychological status and psychosocial adaptation to TMD is also available (Samuel F. Dworkin, DDS, PhD).

Three levels of activity are undertaken for purposes of yielding RDC/TMD clinical examiners who are standardized in their examination, diagnosis and assessment procedures:

1. Training:  Training protocols describe methods by which individual examiners become familiar with RDC/TMD specific examination methods, materials and sequencing of clinical examination procedures.

2. Calibration:  Calibration protocols describe how examiners compare with other examiners in their RDC/TMD examination findings at the same site and/or with a Gold Standard Examiner (GSE).  Calibration methods involve more than one examiner examining the same person, either using co-examiners, other volunteers, the GSE and/or sometimes, patients.

3. Reliability Assessment:  Clinical reliability of RDC/TMD examiners is assessed through formal, carefully specified and carefully executed reliability studies according to both RDC/TMD examination specifications and accepted scientific standards for conducting such inter-rater-reliability assessments.  These reliability studies involve all relevant examiners in training at a particular site and usually at least one GSE.  All examiners clinically examine patients and some asymptomatic controls in a random or quasi-random (latin square) sequence designed to control for order effects.