Factor and Rasch analysis of the Fonseca anamnestic index for the diagnosis of myogenous temporomandibular disorder.
Delaine Rodrigues-Bigaton, Ester M de Castro, Paulo F Pires
PMID 28460710WHAT IT FOUND
The Fonseca index for myogenous TMD did not behave as a single score.
It split into separate symptom groups, and the jaw and TMJ group was the main one.
Key findings
01The factor analysis showed the index was not one dimension. It separated into a jaw and TMJ group (items 1, 2, 3, 6, and 7), a neck pain/headache/stress group (items 4, 5, and 10), and a parafunctional habits/malocclusion group (items 8 and 9).
02The jaw and TMJ group explained the largest proportion of variance and, when analyzed alone, had adequate internal consistency and adequate item fit.
03Within that group, item 2 was the most difficult and item 7 the easiest.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study included only women aged 18 to 40 with myogenous TMD, so it may not apply to men, younger or older adults, or other TMD subtypes. The sample came from a university community, which may limit how widely the results apply. The index was evaluated only in Brazilian Portuguese, so it cannot be assumed to work in other languages. The authors did not establish a diagnostic cutoff, test accuracy for the main dimension alone, or measure reliability over time and responsiveness to treatment. The items did not discriminate volunteers with very high or very low ability.
Declared interests
The authors declare no conflicts of interest.
The easy way to misread this
Do not read this as proof that the Fonseca index can diagnose myogenous TMD or monitor treatment. It showed that the index is multidimensional and that one jaw and TMJ group fit the model. The authors state it does not replace clinical evaluation and that a cutoff point still needs to be defined.