# The Potential of Percent Agreement as an Adjunctive Diagnostic Tool for Acute Temporomandibular Disorder

## TL;DR

This study explores how the percent agreement between self-reported and clinically identified pain sites in acute TMD can help improve diagnosis and treatment outcomes.

## Contribution

The study introduces percent agreement as a potential diagnostic and prognostic tool for acute TMD.

## Key findings

- Lower percent agreement correlates with higher stress, depression, and poor treatment outcomes.
- Percent agreement can predict residual pain after treatment with 41.2% accuracy.
- Patients with lower agreement show more parafunctional oral habits and somatization.

## Abstract

Background/Objectives: It is well established that individuals with chronic temporomandibular disorder (TMD) exhibit differences in their physical and psychosocial characteristics from those with acute TMD. However, few studies have analyzed the physical and psychosocial characteristics of patients with acute TMD. The objective of this cross-sectional study is twofold: first, to ascertain whether there are differences in physical and psychosocial factors among patients with acute TMD based on the percent agreement between patient-reported pain sites and pain sites identified through standardized palpation and, second, to determine the potential of percent agreement as a diagnostic and prognostic factor. Methods: We analyzed physical and psychosocial factors in 309 patients diagnosed with acute TMD. Of these, 171 patients were selected for an analysis of their response to treatment. These patients were divided into three groups based on their percent agreement: Group A (agreement under 80%), Group B (agreement 80–89%), and Group C (agreement 90% or over) in the initial analysis and Group a (agreement under 80%), Group b (agreement 80–89%), and Group c (agreement 90% or over) in the subsequent analysis. This study was approved by the Ethics Committee of Pusan National University Dental Hospital (IRB No. 2023-05-011, 25 May 2023). Results: The lower the percent agreement, the greater the parafunctional oral habits, stress, chronicity, somatization, depression, anxiety, and number of painful sites. A lower percent agreement was associated with poorer treatment outcomes. The percent agreement demonstrated a 41.2% capacity to predict residual pain after treatment. Conclusions: Clinicians can utilize percentage agreement as an adjunctive diagnostic tool to provide more suitable treatments to patients.