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Journal of Dental Research
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*Joint Disorders
*Temporomandibular Joint Dysfunction
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Smallest Detectable Difference in Outcome Variables Related to Painful Restriction of the Temporomandibular Joint

Th.J.B. Kropmans

Department of Oral and Maxillofacial Surgery, University Hospital Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands

P.U. Dijkstra

Department of Oral and Maxillofacial Surgery, University Hospital Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands

B. Stegenga

Department of Oral and Maxillofacial Surgery, University Hospital Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands

R. Stewart

Northern Center for Human Health Care Research, University of Groningen

L.G.M. de Bont

Department of Oral and Maxillofacial Surgery, University Hospital Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands

The smallest detectable difference is the smallest statistically significant change in measurement results. In the field of temporomandibular disorders, the smallest detectable difference is not a commonly used concept. Most outcome studies are based on comparisons of group means, although this does not provide information about individual changes or about the clinical relevance thereof. The smallest detectable difference for maximal mouth opening was calculated from previously published reliability coefficients and the standard deviations of different samples of healthy subjects and patients with complaints of the temporomandibular joint. The smallest detectable difference of pain intensity measured with different visual analogue scales was calculated from the reliability coefficients and standard deviations of a heterogeneous group of pain patients. The smallest detectable difference of function impairment was calculated for a group of patients with complaints of the temporomandibular joint. For maximal mouth opening in healthy subjects, the smallest detectable difference was 5 mm. Repeated measurements improved it to 3 mm. The smallest detectable difference on a visual analogue scale was 28 mm for actual pain intensity and 22 mm for minimal pain as well as for maximal pain intensity. For total function impairment of patients with complaints of the temporomandibular joint, the smallest detectable difference was 8 units on a 0 to 68 scale.

Key Words: therapeutic outcome • statistics • generalizability study • decision study • clinical decision • evidence-based medicine • reliability

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Journal of Dental Research, Vol. 78, No. 3, 784-789 (1999)
DOI: 10.1177/00220345990780031101
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Th.J.B. Kropmans, P.U. Dijkstra, A. van Veen, B. Stegenga, and L.G.M. de Bont
The Smallest Detectable Difference of Mandibular Function Impairment in Patients with a Painfully Restricted Temporomandibular Joint
Journal of Dental Research, August 1, 1999; 78(8): 1445 - 1449.
[Abstract] [PDF]

This Article
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*Joint Disorders
*Temporomandibular Joint Dysfunction
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