DC/TMD 检查者协议：检查者间可靠性的纵向评估
DC/TMD Examiner Protocol: Longitudinal Evaluation on Interexaminer Reliability.
作者信息
Skeie Marit Slåttelid, Frid Paula, Mustafa Manal, Aßmus Jörg, Rosén Annika
机构信息
Department of Clinical Dentistry, Pediatric Dentistry, The Faculty of Medicine, University of Bergen, Bergen, Norway.
Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway and Public Dental Service Competence Centre of North Norway and Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromsø, Norway.
出版信息
Pain Res Manag. 2018 Sep 26;2018:7474608. doi: 10.1155/2018/7474608. eCollection 2018.
OBJECTIVES
The objectives of this study were to assess the interexaminer agreement between one "reference" (gold standard) and each of two examiners, using the DC/TMD examination method, Axis I and to evaluate whether a recalibration changed reliability values.
METHODS
Participants (4 healthy and 12 TMD patients) in 2013 underwent a clinical examination according to DC/TMDs, Axis I. In 2014, additionally 16 participants (4 healthy and 12 TMD patients) were recruited. Two trainee examiners (one more experienced) and one "reference examiner" (gold standard) at both sessions assessed the participants. Calibration preparation (2013): The clinical protocol was sent to the trainee examiners with a request that its verbal commands should be learned by heart. An eight-hour-course was provided on the day preceding the examination session day. Recalibration preparation (2014): The same examiners in advance to this year's examination session were also asked to recapture the protocol's instructions (verbal commands to be learned by heart) and go through the information from the 2013 course and encouraged to contact by e-mail in case of unclear subjects. At a meeting prior to the examination session, they were also given the opportunities to ask questions. The interexaminer agreements in 2013 and 2014 between the "reference" and each examiner were analysed using Bland-Altman plots, intraclass correlation coefficient, Cohen's kappa, and consistency values.
RESULTS
For the majority of the gathered data, no clear change of agreement between 2013 and 2014 could be observed, and only one muscle zone in 2014 could show any clear difference in agreement between the examiners.
CONCLUSIONS
No clear and consistent difference in the level of agreement between the two examiners could be observed, although one was more experienced than the other. Likewise, for most components of the DC/TMD tool, recalibration of examiners did not change the reliability findings.
目的
本研究的目的是使用DC/TMD检查方法的轴I评估一位“参考”（金标准）检查者与两位检查者中每一位之间的检查者间一致性，并评估重新校准是否会改变可靠性值。
方法
2013年的参与者（4名健康者和12名颞下颌关节紊乱病患者）按照DC/TMD轴I接受了临床检查。2014年，另外招募了16名参与者（4名健康者和12名颞下颌关节紊乱病患者）。在两个阶段，两名实习检查者（其中一名经验更丰富）和一名“参考检查者”（金标准）对参与者进行了评估。校准准备（2013年）：将临床方案发送给实习检查者，并要求他们牢记其中的口头指令。在检查阶段前一天提供了一个八小时的课程。重新校准准备（2014年）：要求今年检查阶段的相同检查者重新掌握方案的指令（需牢记的口头指令），复习2013年课程的信息，并鼓励他们在遇到不明确的问题时通过电子邮件联系。在检查阶段前的一次会议上，他们也有机会提问。使用Bland-Altman图、组内相关系数、Cohen's kappa和一致性值分析了2013年和2014年“参考”检查者与每位检查者之间的检查者间一致性。
结果
对于大多数收集到的数据，2013年和2014年之间未观察到一致性的明显变化，2014年只有一个肌肉区域在检查者之间的一致性上显示出任何明显差异。
结论
尽管一名检查者比另一名经验更丰富，但未观察到两名检查者之间一致性水平的明显和一致差异。同样，对于DC/TMD工具的大多数组成部分，检查者的重新校准并未改变可靠性结果。
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