Interexaminer reliability of the German version of the DC/TMD

Aim Verification of the interrater reliability of axis I diagnoses of the German version of the DC/TMD. The hypothesis was that the DC/TMD protocol yields comparable results, if examiner instructions are closely followed. Material and Methods A culturally equivalent German translation of the DC/TMD was developed. During a 1-day calibration workshop at the University of Heidelberg, three examiners were trained by the DC/TMD Training and Calibration Center. According to the calibration guidelines, 16 models (11 cases, five non-cases) were examined by four experienced TMD specialists. Reliability was calculated with reference to the reference standard examiner as percentage agreement and kappa coefficients for DC/TMD diagnoses and intraclass correlation coefficients (ICCs) for findings. Results Excellent reliability was achieved for the diagnoses myalgia, myofascial pain with referral, arthralgia, headache attributed to TMD, disc displacement (DD) with reduction, DD without reduction without limited opening (kappa = 0.85 horizontal ellipsis 1.00). Degenerative joint disease was diagnosed with substantial agreement (kappa = 0.64), DD with reduction with intermittent locking and DD without reduction with limited opening were not present in our sample. Overall percentage agreement was 94%-100% for all diagnoses. Conclusion The German version of the DC/TMD shows very good reliability and can be recommended for the use in clinical and research settings.