Diagnostic Accuracy of Different Evaluation Approaches for the 5Ts Screener in Temporomandibular Disorder Assessment

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PURPOSE: This study aimed to compare the diagnostic performance of different 5Ts evaluation approaches and to establish the most accurate method and cut-off point (CP) in non-clinical populations. MATERIALS AND METHODS: A cross-sectional study was conducted with 278 participants (mean age 22.17 years [SD 1.82]) recruited from a large private university. Participants completed a survey including demographics, the 5Ts with no/yes responses, and 5Ts-F with frequency options. TMD diagnoses were established using the DC/TMD protocol and algorithms. Diagnostic accuracy was analyzed using the area under the receiver operating characteristic (ROC) curves, sensitivity, specificity, and predictive values for four approaches: A1 (5Ts; conventional), A2 (5Ts; CP 1.5), A3 (5Ts-F; CP 1.5), and A4 (5Ts-F; CP 2.5). RESULTS: Among participants, 68.7% received a DC/TMD diagnosis. A1 identified 72.3% as TMD-positive, showing AUCs of 0.94 for all TMDs, PT, and IT. A2 to A4 had AUCs below 0.9. A1's sensitivity/specificity were 100%/88.5%. When items were analyzed separately, A1's AUCs increased to 0.99 for PT and 0.95 for IT. CONCLUSIONS: The conventional 5Ts assessment method was the most accurate, and total scores of ≥1 can identify the presence of TMDs in non-clinical samples when points are assigned for no/yes responses.

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