Objective
We sought to systematically assess the quality of all clinical practice guidelines
(CPGs) describing diagnosis and management of temporomandibular joint disorders (TMDs)
using the Appraisal of Guidelines for Research and Evaluation instrument.
Study Design
CPGs detailing all aspects of diagnosis and management (both conservative and nonconservative)
for TMDs were reviewed.
Results
Thirteen guidelines met inclusion criteria. The highest-scoring domain across guidelines
was clarity of presentation (68.3%); the lowest-scoring domain was editorial independence
(31.9%). The highest-scoring guideline described traditional Korean medicine approaches
to the management of TMDs, earning a mean score of 79.2% across the six quality domains.
Only three CPGs met a quality threshold of >60% in at least five domains, qualifying
as 'high' per the Appraisal of Guidelines for Research and Evaluation criteria: these
guidelines were the Korean medicine guidelines, Research Diagnostic Criteria for Temporomandibular
Disorders (RDC/TMD) guidelines for diagnostic classification of TMDs, and the Japanese
Society for the Temporomandibular Joint guidelines. An average intraclass correlation
coefficient of 0.79 was calculated across all domains, denoting very strong agreement
between independent reviewers.
Conclusion
We identified a significant lack of quality in multiple areas of CPG development for
the diagnosis and therapeutic management of TMDs, suggesting a need for new comprehensive
and rigorously developed guidelines addressing TMDs.
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Article info
Publication history
Published online: November 02, 2021
Accepted:
October 25,
2021
Received in revised form:
October 7,
2021
Received:
June 15,
2021
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
