Development and Validation of a Disease-Specific Oromandibular Dystonia Rating Scale (OMDRS)
Bibliographic record
Abstract
Background: Oromandibular dystonia manifests with sustained or task-specific contractions of the masticatory, tongue, and/or other muscles in the stomatognathic system. Since its symptoms can vary, it has been difficult to objectively measure disease severity and post-treatment changes. Objective: To develop and validate a comprehensive measurement tool for oromandibular dystonia. Methods: An examiner-rated scale included three subscales for severity, disability, and pain, modified specifically for oromandibular dystonia from the Toronto Western Spasmodic Torticollis Rating Scale-2. To evaluate the severity of each subtype of oromandibular dystonia, four of the six items were selected according to the subtype (jaw closing dystonia, tongue dystonia, jaw opening dystonia, jaw deviation [protrusion] dystonia, and lip dystonia). A patient-administered questionnaire based on clinical features and other relevant aspects associated with oromandibular dystonia was developed, which included five subscales: general, eating, speech, cosmetic, and social/family life. The questionnaire, examiner-rated scale, and four subscales (sleep, annoyance, mood, and psychosocial functioning) of the Cervical Dystonia Impact Profile-58 were combined to construct the oromandibular dystonia rating scale (OMDRS). The reliability and validity of the scale were assessed using clinimetric testing. Results: Six hundred and eighteen patients with oromandibular dystonia (394 women and 224 men; mean age, 51.7 years) were evaluated by the OMDRS. The overall OMDRS showed high-level internal consistency measured by Cronbach’s alpha (0.95) with a logical factor structure. Cronbach’s alpha for the subscales was satisfactory to excellent, ranging from 0.72 to 0.94. All items revealed acceptable inter-rater reliability (kappa>0.4, interclass correlation coefficient>0.6). Repeated ratings of videotapes revealed acceptable intra-rater reliability for all items (kappa>0.76, interclass correlation coefficient>0.86). Test-retest reliability showed a significant (p<0.001) correlation efficiency. The OMDRS showed significant (p<0.001) convergent and discriminant validity and significant (p<0.001) sensitivity to changes after botulinum toxin therapy. Conclusion: The OMDRS can be useful for the comprehensive evaluation of disease severity, disability, psychosocial functioning, and impact on the quality of life as well as therapeutic changes in patients with oromandibular dystonia.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.015 | 0.021 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".