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S R Levitt

Publications and source records attributed to S R Levitt.

15 recordsLinked to original sources
PubMed1991

Predictive value: a model for dentists to evaluate the accuracy of diagnostic tests for temporomandibular disorders as applied to a TMJ scale.

The predictive value model for assessing the accuracy of diagnostic test results in the individual patient with a temporomandibular disorder is described. The use of predictive values to help the clinician ascertain the degree of confidence to be placed in diagnostic test results is illustrated. The predictive value model is used to study the accuracy of the TMJ Scale as a diagnostic tool. For all base rates between 0% and 100%, the predictive values of the TMJ Scale result in a gain in accuracy in confirming or excluding a diagnosis of a temporomandibular disorder. The TMJ Scale provides the dentist with improved accuracy of diagnostic decisions regarding the presence of temporomandibular disorders throughout the entire range of base rates found in clinical practice. Application of the predictive value model helps the dentist avoid serious diagnostic errors that could place both the patient and dentist at unnecessary risk.

Humans↗
PubMed1991

The TMJ scale and undetected brain tumors in patients with temporomandibular disorders.

The symptoms of non-temporomandibular disorders, including mass lesions of the central nervous system, may mimic or be masked by symptoms of temporomandibular disorders, and thus not be detected. The dentist must remain alert to this possibility and maintain a high level of suspicion. Three cases illustrate how the TMJ Scale was used in patients having internal derangements of the temporomandibular joints to screen for and detect non-temporomandibular disorders, which, on further evaluation or referral, led to the diagnosis of brain tumors that had not been detected previously.

Adult↗
PubMed1990

Chronic TM disorder and non-TM disorder pain: a comparison of behavioral and psychological characteristics.

The purpose of this paper is to determine whether patients with chronic temporomandibular disorder (TMD) pain manifest behavioral, experimental, and psychological characteristics similar to patients with other chronic pain illnesses. The Chronic Pain Battery (CPB), a multidimensional assessment tool for chronic pain patients, was used to compare several important variables between 78 TM disorder (TMD) patients and 98 non-TMD chronic pain patients. The study found that chronic TMD patients had lower "usual" pain intensity and suffering levels, fewer vegetative symptoms associated with depression, higher pain tolerance, less impairment of activity, more hope about treatment outcome, lower health care system utilization, but higher reported stress levels than non-TMD chronic pain patients. The two groups manifested no significant differences in use of narcotics, sedatives, and sleeping pills; levels of depression, anxiety, somatization, hostility, or psychoticism; illness behavior reinforcement in their social surroundings; or ratings of problems with work, family, self-esteem, or suicidal impulses. These findings suggest that chronic TMD pain patients (with a symptom duration of over six months) are behaviorally and psychologically similar to non-TMD chronic pain patients, but that they differ in their perceptions of their disorder, rendering them less handicapped by their problems. Psychological, social, and behavioral treatment methods useful for treating chronic pain syndrome may thus also be applied along with dental therapy for optimal treatment of TMD associated with chronic pain.

Adult↗
PubMed1990

The predictive value of the TMJ scale in detecting psychological problems and non-TM disorders in patients with temporomandibular disorders.

Identification of psychological problems and non-TM disorders in patients with temporomandibular disorders (TMD) is an essential but often difficult task. The TMJ Scale is a self-report symptom inventory that can detect these problems. The predictive value model for assessing the accuracy of diagnostic tests is reviewed. This model is then used to study the Psychological Factors, Stress, and Non-TM Disorder scales of the TMJ Scale to determine whether they add accuracy to the diagnostic process compared with dentists' predictions. The results suggest that these scales provide an improvement in diagnostic accuracy in ruling out and in confirming these problems in the individual patient throughout the range of base rates found in clinical practice. The application of the principles of predictive values to test interpretation helps the dentist determine what level of confidence may be placed in the diagnostic test results and associated clinical decisions.

Humans↗
PubMed1990

TMD symptomology among denture patients.

The relationship between denture wearing and symptoms of temporomandibular disorder (TMD) was assessed with a psychometric test specifically developed to measure TMD symptoms. The subjects were 278 denture patients and 36 elderly patients with a diagnosed TMD. Denture wearers were found to have a higher prevalence of TMD symptoms than the normal population, but the average level of symptoms was of low intensity and not clinically significant. Denture wearers reported fewer TMD symptoms and less stress and psychological distress than TMD patients. Responses to test items assessing perceived malocclusion apparently were not affected by denture wearing.

Adolescent↗
PubMed1990

Predictive value of the TMJ scale in detecting clinically significant symptoms of temporomandibular disorders.

It is important for the dentist to differentiate between subclinical and clinically significant symptoms of TMD. The TMJ Scale tests for clinical significance of pain report, palpation pain, perceived malocclusion, joint dysfunction, and range of motion limitation. To evaluate the accuracy of test results in a patient, the predictive values for each scale must be known. The positive and negative predictive values are calculated and found to produce an increase in diagnostic accuracy of the TMJ Scale compared to pre-test predictions throughout most of the base rate range found in clinical practice. The use of predictive values to interpret test results correctly and to confirm or rule out clinically significant symptoms is described.

Facial Pain↗
PubMed1989

TMJ testing.

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Humans↗