Influence of examiner calibration on clinical and MRI diagnosis of temporomandibular joint disc displacement: a systematic review and meta-analysis.

IF 2.9 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Dento maxillo facial radiology Pub Date : 2024-09-01 DOI:10.1093/dmfr/twae027

Lucas Machado Maracci, Gleica Dal Ongaro Savegnago, Raquel Pippi Antoniazzi, Mariana Marquezan, Tatiana Bernardon Silva, Gabriela Salatino Liedke

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Abstract

Objectives: This study aimed to verify the accuracy of clinical protocols for the diagnosis of disc displacement (DD) compared with MRI, considering examiners' calibration.

Methods: PubMed, Cochrane (Central), Scopus, Web of Science, LILACS, Embase, Science Direct, Google Scholar, and DANS EASY Archive databases were searched. Two reviewers independently screened and selected the studies. A meta-analysis was conducted using the R Statistical software. Results are shown using sensitivity and specificity, and 95% confidence intervals.

Results: Of the 20 studies included in the systematic review, only three were classified as low risk of bias. Seventeen studies were included in the meta-analysis. Compared to MRI, clinical protocols showed overall sensitivity and specificity of 0.75 (0.63-0.83) and 0.73 (0.59-0.84) for DD diagnosis, respectively. For DD with reduction, sensitivity was 0.64 (0.48-0.77) and specificity was 0.72 (0.48-0.87). For DD without reduction, sensitivity was 0.58 (0.39-0.74) and specificity 0.93 (0.83-0.97). Only 8 studies reported examiner calibration when performing clinical and/or MRI evaluation; nevertheless, calibration showed a tendency to improve the diagnosis of DD.

Conclusion: The sensitivity and specificity of clinical protocols in the diagnosis of DD are slightly below the recommended values, as well as the studies lack calibration of clinical and MRI examiners. Examiner calibration seems to improve the diagnosis of DD.

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检查者校准对颞下颌关节椎间盘移位的临床和 mri 诊断的影响：系统回顾和荟萃分析。

研究目的本研究旨在验证与磁共振成像（MRI）相比，临床方案诊断椎间盘移位（DD）的准确性，同时考虑检查者的校准：方法：检索了 PubMed、Cochrane（Central）、Scopus、Web of Science、LILACS、Embase、Science Direct、Google Scholar 和 DANS EASY Archive 数据库。两名审稿人独立筛选了这些研究。使用 R 统计软件进行了荟萃分析。结果以灵敏度、特异性和 95% 置信区间表示：在纳入系统综述的 20 项研究中，只有 3 项被归类为低偏倚风险。17项研究被纳入荟萃分析。与磁共振成像相比，临床方案诊断 DD 的总体敏感性和特异性分别为 0.75（0.63-0.83）和 0.73（0.59-0.84）。对于缩窄的 DD，敏感性为 0.64（0.48-0.77），特异性为 0.72（0.48-0.87）。对于无缩小的 DD，敏感性为 0.58（0.39-0.74），特异性为 0.93（0.83-0.97）。只有 8 项研究报告了在进行临床和/或磁共振成像评估时对检查者进行校准；然而，校准显示出改善 DD 诊断的趋势：结论：临床方案诊断 DD 的灵敏度和特异性略低于推荐值，且研究缺乏对临床和 MRI 检查者的校准。检查者校准似乎能提高 DD 的诊断率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Dento maxillo facial radiology 医学-核医学

CiteScore

5.60

自引率

9.10%

发文量

审稿时长

4-8 weeks

期刊介绍： Dentomaxillofacial Radiology (DMFR) is the journal of the International Association of Dentomaxillofacial Radiology (IADMFR) and covers the closely related fields of oral radiology and head and neck imaging. Established in 1972, DMFR is a key resource keeping dentists, radiologists and clinicians and scientists with an interest in Head and Neck imaging abreast of important research and developments in oral and maxillofacial radiology. The DMFR editorial board features a panel of international experts including Editor-in-Chief Professor Ralf Schulze. Our editorial board provide their expertise and guidance in shaping the content and direction of the journal. Quick Facts: - 2015 Impact Factor - 1.919 - Receipt to first decision - average of 3 weeks - Acceptance to online publication - average of 3 weeks - Open access option - ISSN: 0250-832X - eISSN: 1476-542X