Man Ther. 1996 Dec; 1(5): 250-257.

Diagnostic tests for temporomandibular disorders: an assessment of the methodologic quality of research reviews.

Gross AR, Haines T, Thomson MA, Goldsmith C, McIntosh J.

Department of Clinical Epidemiology and Biostatistics and Occupational Health Program, Chedoke-McMaster Hospitals; McMaster University, School of Rehabilitation Science, Hamilton, Ontario, Canada

SUMMARY. The objective of this study was to assess review articles of temporomandibular disorder (TMD) diagnostic tests for methodological quality and to establish the need for a systematic reviewing process. Computerized bibliographic database searches from 1983 to December 1996, information requests from authors, and review of reference lists of all retrieved reports were used to identify relevant reviews. After applying selection criteria, two investigators independently reviewed the articles. Each review article was evaluated independently for methodological quality. Agreement between reviewers was measured using quadratic weighted kappa.Forty-five of 53 review articles met the selection criteria. No review described the search methods, selection criteria, demonstrably avoided selection bias or pooled data of primary studies. Three of 45 articles assessed the internal validity and reliability of the studies included in their review. Major to extensive methodological flaws were noted across all reviews.This critique of methodologic quality in TMD diagnostic review articles supports the need for a systematic reviewing process. Clinicians turning to diagnostic reviews to aid them in synthesizing a large body of literature may wish to apply the described methodologic criteria to separate 'valid' from 'invalid' reviews. Copyright 1996 Harcourt Publishers Ltd.