Clinical, psychological and comorbid characteristics in patients with acute and chronic painful temporomandibular disorders: a baseline analysis of acute to chronic transition project
Bibliographic record
Abstract
Although most cases of Temporomandibular Disorders (TMD) are mild and self-limiting, about one third of these patients will continue to suffer from moderate to severe levels of pain, disability, psychological distress and lower quality of life, independent of the treatment received.Thus, it is crucial to prevent painful TMD from becoming chronic, which is more difficult to manage.However, as stated by the National Institutes of Health (NIH) "we do not fully understand how acute progresses to chronic pain at any level, from molecular to behavioral".Our systematic review is in agreement with this previous NIH statement.The aim of this cross-sectional analysis was to identify the clinical, psychological, and comorbid factors among acute and chronic painful TMD.One hundred and eleven participants were recruited for this study.TMD diagnosis was established according to the RDC/TMD or DC/TMD; 22 and 89 where classified as acute and chronic painful TMD respectively.Our results showed that participants with chronic painful TMD were more likely to report headache located behind the eyes or inside the head (Odds ratio [OR] = 4.14, P = 0.02), pain in the legs (OR= 9.05, P = 0.04) or neck (OR = 3.10, P = 0.03) than the acute cases.Participants presenting at least one painful comorbidity (OR = 3.35, P = 0.02), or those with more than one (OR = 1.49, 95%CI = 1.01-2.20,P = 0.04) were more likely to have chronic painful TMD.A borderline association was noted with worst pain intensity (P = 0.09).Psychological factors were not different between groups.Results indicate that headache and comorbidities should be considered as important risk factors implicated in the transition from acute to chronic painful TMD.xv RÉSUMÉ Malgré le fait que la plupart des cas de Dysfonction de l'Articulation Temporomandibulaire (DATM) restent tolérables, environ un tiers des patients atteints continuent de souffrir de douleurs intenses, d'infirmité, de détresse psychologique et d'une qualité de vie inférieure, indépendamment du traitement reçu.Il est donc important de prévenir la progression de cette maladie, car la DATM chronique douloureuse est un cas beaucoup plus difficile à gérer.Par contre, tel qu'il est énoncé par le National Institutes of Health (NIH), « nous ne comprenons pas entièrement comment la douleur aiguë devient chronique à tous les niveaux, du niveau moléculaire au niveau comportemental » et notre revue systématique est en accord avec celle-ci.Le but de cette analyse analyse transversale est d'identifier les facteurs cliniques et psychologiques, ainsi que la comorbidité parmi les cas de DATM douloureuses aiguës et chroniques.Cent-onze participants ont été recrutés pour l'étude.Le diagnostic de la DATM a été basé en fonction du RDC/TMD ou du DC/TMD; 22 et 89 ont été classés comme étant atteints de DATM aiguë et chronique respectivement.Nos résultats démontrent que les participants atteints de DATM chronique étaient plus susceptibles à déclarer des maux de tête situés derrière les yeux ou à l'intérieur la tête (Odds ratio [OR] = 4.14, P = 0.02), douleur dans les jambes (OR= 9.05, P = 0.04) ou dans le cou (OR = 3.10, P = 0.03) comparé aux cas de DATM aiguës.Les participants présentant au moins une comorbidité douloureuse (OR = 3.35, P = 0.02) ou plusieurs (OR = 1.49, 95%CI = 1.01-2.20,P = 0.04) étaient plus susceptibles à avoir un cas de DATM chronique douloureuse.Une association borderline a été notée avec la douleur la plus intense (P= 0.09).Les facteurs psychologiques n'ont pas différé entre les groupes.Les résultats indiquent que les maux de têtes et les comorbidités devraient être considérés comme étant des facteurs de risque importants dans la transition de la DATM aiguë à chronique.xvi
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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 | 0.002 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
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".