Objective: To identify assessment tools used to evaluate patients with temporomandibular disorders (TMD) considered to be clinically most useful by a panel of international experts in TMD physical therapy (PT). Methods:A Delphi survey method administered to a panel of international experts in TMD PT was conducted over three rounds from Results: Twenty-three experts (completion rate: 23/25) completed all three rounds of the survey for three clinical test categories: 1) questionnaires, 2) pain screening tools and 3) physical examination tests. The following was the consensus-based decision regarding the identification of the clinically most useful assessments. (1) Four of 9 questionnaires were identified: Jaw Functional Limitation (JFL-8), Mandibular Function Impairment Questionnaire (MFIQ), Tampa Scale for Kinesiophobia for Temporomandibular disorders (TSK/TMD) and the neck disability index (NDI). (2) Three of 8 identified pain screening tests: visual analog scale (VAS), numeric pain rating scale (NRS) and pain during mandibular movements. (3) Eight of 18 identified physical examination tests: physiological temporomandibular joint (TMJ) movements, trigger point (TrP) palpation of the masticatory muscles, TrP palpation away from the masticatory system, accessory movements, articular palpation, noise detection during movement, manual screening of the cervical spine and the Neck Flexor Muscle Endurance Test. Conclusion: After three rounds in this Delphi survey, the results of the most used assessment tools by TMD PT experts were established. They proved to be founded on test construct, test psychometric properties (reliability/validity) and expert preference for test clusters. A concordance with the screening tools of the diagnostic criteria of TMD consortium was noted. Findings may be used to guide policymaking purposes and future diagnostic research. K E Y W O R D S assessments, delphi study, physical therapy, TMD | 687 PIEKARTZ ET Al.

Purpose: To assess the diagnostic validity of clinical tests for temporomandibular internal derangement relative to magnetic resonance imaging (MRI). Methods: MEDLINE and Embase were searched from 1994 through 2009. Independent reviewers conducted study selection; risk of bias was assessed using Quality Assessment of studies of Diagnostic Accuracy included in Systematic reviews (QUADAS); b9/14) and data abstraction. Overall quality of evidence was profiled using Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Agreement was measured using quadratic weighted kappa (kw). Positive (þ) or negative (À) likelihood ratios (LR) with 95% CIs were calculated and pooled using the DerSimonian-Laird method and a random-effects model when homogeneous (I 2 b 0.40, Q-test p a 0.10). Findings of this review will assist clinicians in deciding which diagnostic tests to use when internal derangement is suspected. The literature search revealed a lack of high-quality studies; further research with adequate description of patient populations, blinded assessments, and both sagittal and coronal MRI planes is therefore recommended.Key Words: diagnosis; magnetic resonance imaging; predictive value of tests; temporomandibular joint disorders. RÉ SUMÉObjectif : É valuer la validité du diagnostic ré sultant de tests cliniques en imagerie de ré sonance magné tique (IRM) pour le dé pistage du dé rangement interne de l'articulation temporo-mandibulaire (ATM). Mé thode : Une recherche a é té effectué e dans les bases de donné es MEDLINE et Embase pour les anné es 1994 à 2009. Des examinateurs indé pendants ont procé dé au choix des é tudes ré pertorié es ; les risques de biais ont é té é valué s à l'aide de l'é chelle QUADAS (Quality Assessment of studies of Diagnostic Accuracy included in Systematic reviews ), visant à é valuer la qualité des é tudes sur la fiabilité diagnostique incluses dans les revues systé matiques (le pointage obtenu a é té b9/14) et à l'aide d'abstraction des donné es. Le profil de la qualité globale des preuves a é té é tabli avec l'é chelle GRADE (Grading of Recommendations Assessment, Development, and Evaluation). Le degré d'accord a é té mesuré à l'aide du coefficient quadratique kappa pondé ré (kw). Les rapports de vraisemblance (RV) positifs ( þ ) ou né gatifs ( À ) avec intervalles de confiance de 95 % ont é té calculé s et groupé s suivant la mé thode de DerSimonian-Laird et à l'aide d'un modè le à effets alé atoires lorsque les donné es é taient homogè nes (I 2 b 0,40, test-Q p a 0,10). Ré sultats : Nous avons retenu 8 des 36 é tudes identifié es. Les preuves voulant que les tests individuels de dé viation (RVþ : 6,37 [95 % IC : 2,(13)(14)(15)(16)(17)(18)(19)03]) et de cré pitation ([RV : 5,) soient fiables é taient de trè s faible qualité , alors qu'un ensemble de tests regroupant cré pitation, dé viation, douleur et ouverture limité e de la bouche sont les plus valables au moment de dé terminer s'il y a effectivement dé rangement interne sans ré duction (RVþ : 6,37 [95 % IC :...

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