Dimensionality of the Fonseca Anamnestic Index and validation of its short-form derivative
DOI:
https://doi.org/10.2340/aos.v84.42960Keywords:
Temporomandibular disorders, general population, questionnaires, validity, methodsAbstract
Objectives: Recently, the Short-Form Fonseca Anamnestic Index (SFAI) was shown to have high diagnostic accuracy when compared to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) in patient samples. This study investigated the dimensionality of the parent instrument (Fonseca Anamnestic Index [FAI]) and validated its main component using Rasch analysis in non-patient populations.
Methods: FAI data from a total of 901 participants from Singapore and Indonesia with a mean age 19.30 ± 1.48 years (65.0% women) were examined. Of these, 53.8% were FAI positive and 46.2% were FAI negative. Principal Component Analysis (PCA) was performed to extract the main component of the FAI using an eigenvalue > 1.0 and direct oblimin rotation with item loading of > 0.40. Rasch analysis was subsequently carried out on the items of the main component.
Results: The FAI was found to be multidimensional with the main component involving items F1, F2, F3, F6, and F7 which were the items of the SFAI. The SFAI had moderate internal consistency (Cronbach alpha = 0.63) and fitted the Rasch model with person and item infit/outfit mean square (MnSq) values of 0.98/0.96 and 1.00/0.96 logits respectively. The infit/outfit MnSq of the SFAI items ranged from 0.82 to 1.06 logits with Item F2 (side-movement difficulty) being the most difficult and item F3 (muscle pain) the easiest.
Conclusions: The FAI is multidimensional with the main component comprising the five items of the SFAI that fitted the Rasch model. With its good Rasch validity, separation, and reliability, the SFAI is a promising tool for TMD screening.
Downloads
References
List T, Jensen RH. Temporomandibular disorders: old ideas and new concepts. Cephalalgia. 2017;37:692–704. https://doi.org/10.1177/0333102416686302 DOI: https://doi.org/10.1177/0333102416686302
National Academies of Sciences, Engineering, and Medicine, Health and Medicine Division, Board on Health Care Services, Board on Health Sciences Policy, Committee on Temporomandibular Disorders (TMDs). From research discoveries to clinical treatment. In: Yost O, Liverman CT, English R, Mackey S, Bond EC, editors. Temporomandibular disorders: priorities for research and care. Washington, DC: National Academies Press (US); 2020: 24–29.
Bueno CH, Pereira DD, Pattussi MP, Grossi PK, Grossi ML. Gender differences in temporomandibular disorders in adult populational studies: a systematic review and meta-analysis. J Oral Rehabil. 2018;45:720–9. https://doi.org/10.1111/joor.12661 DOI: https://doi.org/10.1111/joor.12661
Manfredini D, Guarda-Nardini L, Winocur E, Piccotti F, Ahlberg J, Lobbezoo F. Research diagnostic criteria for temporomandibular disorders: a systematic review of axis I epidemiologic findings. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011;112:453–62. https://doi.org/10.1016/j.tripleo.2011.04.021 DOI: https://doi.org/10.1016/j.tripleo.2011.04.021
Ryan J, Akhter R, Hassan N, Hilton G, Wickham J, Ibaragi S. Epidemiology of temporomandibular disorder in the general population: a systematic review. Adv Dent Oral Health. 2019;10:555787. https://doi.org/10.19080/ADOH.2019.10.555787 DOI: https://doi.org/10.19080/ADOH.2019.10.555787
Dworkin SF, LeResche L. Research diagnostic criteria for temporomandibular disorders: review, criteria, examinations and specifications, critique. J Craniomandib Disord. 1992;6:301–55.
Schiffman E, Ohrbach R, Truelove E, et al. Diagnostic criteria for temporomandibular disorders (DC/TMD) for clinical and research applications: recommendations of the International RDC/TMD Consortium Network and Orofacial Pain Special Interest Group. J Oral Facial Pain Headache. 2014;28:6–27. https://doi.org/10.11607/jop.1151 DOI: https://doi.org/10.11607/jop.1151
Gonzalez YM, Schiffman E, Gordon SM, et al. Development of a brief and effective temporomandibular disorder pain screening questionnaire: reliability and validity. J Am Dent Assoc. 2011;142:1183–91. https://doi.org/10.14219/jada.archive.2011.0088 DOI: https://doi.org/10.14219/jada.archive.2011.0088
Lövgren A, Visscher CM, Häggman-Henrikson B, Lobbezoo F, Marklund S, Wänman A. Validity of three screening questions (3Q/TMD) in relation to the DC/TMD. J Oral Rehabil. 2016;43:729–36. https://doi.org/10.1111/joor.12428 DOI: https://doi.org/10.1111/joor.12428
Fonseca DM, Bonfante G, Valle AL, Freitas SFT. Diagnosis by anamnesis of craniomandibular dysfunction [Diagnóstico pela anamneses da disfunção craniomandibular]. Rev Gaúcha Odontol. 1994;42:23–32.
Zhang MJ, Yap AU, Lei J, Fu KY. Psychometric evaluation of the Chinese version of the Fonseca anamnestic index for temporomandibular disorders. J Oral Rehabil. 2020;47:313–18. https://doi.org/10.1111/joor.12893 DOI: https://doi.org/10.1111/joor.12893
Sánchez-Torrelo CM, Zagalaz-Anula N, Alonso-Royo R, et al. Transcultural adaptation and validation of the Fonseca Anamnestic Index in a Spanish population with temporomandibular disorders. J Clin Med. 2020;9:3230. https://doi.org/10.3390/jcm9103230 DOI: https://doi.org/10.3390/jcm9103230
Alyessary AS, Yap AU, Almousawi A. The Arabic Fonseca Anamnestic Index: psychometric properties and use for screening temporomandibular disorders in prospective orthodontic patients. Cranio. 2023;41:131–8. https://doi.org/10.1080/08869634.2020.1827627 DOI: https://doi.org/10.1080/08869634.2020.1827627
Yap AU, Apipi M, Ismail SM, Yusof ZYM, Kadir K. Psychometric properties of the Malay Fonseca Anamnestic Index for temporomandibular disorders. Cranio. 2024;42:801–8. https://doi.org/10.1080/08869634.2022.2059130. DOI: https://doi.org/10.1080/08869634.2022.2059130
Arikan H, Citaker S, Ucok C. Psychometric properties of the Fonseca Anamnestic Index (FAI) for temporomandibular disorders: Turkish version, responsiveness, reliability, and validity study. Disabil Rehabil. 2024;46:1408–15. https://doi.org/10.1080/09638288.2023.2199221 DOI: https://doi.org/10.1080/09638288.2023.2199221
Gałczyńska-Rusin M, Pobudek-Radzikowska M, Czajka-Jakubowska A. Polish language adaptation and validation of the Fonseca Anamnestic Index for individuals with temporomandibular disorders. Dent Med Probl. 2024;61(5):705–11. https://doi.org/10.17219/dmp/177287 DOI: https://doi.org/10.17219/dmp/177287
Topuz MF, Oghan F, Ceyhan A, Ozkan Y, Erdogan O, Musmul A, et al. Assessment of the severity of temporomandibular disorders in females: validity and reliability of the Fonseca anamnestic index. Cranio. 2023;41:84–7. https://doi.org/10.1080/08869634.2020.1814652 DOI: https://doi.org/10.1080/08869634.2020.1814652
Berni KC, Dibai-Filho AV, Rodrigues-Bigaton D. Accuracy of the Fonseca anamnestic index in the identification of myogenous temporomandibular disorder in female community cases. J Body Mov Ther. 2015;19:404–9. https://doi.org/10.1016/j.jbmt.2014.08.001 DOI: https://doi.org/10.1016/j.jbmt.2014.08.001
Pastore GP, Goulart DR, Pastore PR, Prati AJ, de Moraes M. Comparison of instruments used to select and classify patients with temporomandibular disorder. Acta Odontol Latinoam. 2018;31:16–22.
Pires PF, de Castro EM, Pelai EB, de Arruda ABC, Rodrigues-Bigaton D. Analysis of the accuracy and reliability of the Short-Form Fonseca Anamnestic Index in the diagnosis of myogenous temporomandibular disorder in women. Braz J Phys Ther. 2018;22:276–82. https://doi.org/10.1016/j.bjpt.2018.02.003 DOI: https://doi.org/10.1016/j.bjpt.2018.02.003
Yap AU, Zhang MJ, Lei J, Fu KY. Diagnostic accuracy of the short-form Fonseca Anamnestic Index in relation to the diagnostic criteria for temporomandibular disorders. J Prosthet Dent. 2022;128:977–83. https://doi.org/10.1016/j.prosdent.2021.02.016 DOI: https://doi.org/10.1016/j.prosdent.2021.02.016
Rodrigues-Bigaton D, de Castro EM, Pires PF. Factor and Rasch analysis of the Fonseca anamnestic index for the diagnosis of myogenous temporomandibular disorder. Braz J Phys Ther. 2017;21:120–6. https://doi.org/10.1016/j.bjpt.2017.03.007 DOI: https://doi.org/10.1016/j.bjpt.2017.03.007
Belvedere SL, de Morton NA. Application of Rasch analysis in health care is increasing and is applied for variable reasons in mobility instruments. J Clin Epidemiol. 2010;63:1287–97. https://doi.org/10.1016/j.jclinepi.2010.02.012 DOI: https://doi.org/10.1016/j.jclinepi.2010.02.012
Rasch G. Probabilistic models for some intelligence and attainment tests. Chicago, IL: Mesa Press; 1993.
Wright BD, Stone MH. Best test design: Rasch measurement. Chicago, IL: MESA Press; 1993.
Natu VP, Yap AU, Su MH, Irfan Ali NM, Ansari A. Temporomandibular disorder symptoms and their association with quality of life, emotional states and sleep quality in South-East Asian youths. J Oral Rehabil. 2018;45:756–63. https://doi.org/10.1111/joor.12692 DOI: https://doi.org/10.1111/joor.12692
Yap AU, Marpaung C, Gunardi I. Psychometric properties of the Indonesian Fonseca anamnestic index and the presence/severity of temporomandibular disorders among Indonesian young adults. Cranio. 2024;42:379–86. https://doi.org/10.1080/08869634.20 DOI: https://doi.org/10.1080/08869634.2021.1999615
Linacre JM. Winsteps – Rasch measurement computer program user’s guide. Beaverton, OR: Winsteps.com; 2021.
Field A. Discovering statistics using SPSS. 3rd ed. London: Sage Publications; 2009.
Cunha CM, Almeida Neto OP, Stackfleth R. Main psychometric evaluation methods of measuring instrument’s reliability. Rev Atenção Saúde. 2016;14:98–103. https://doi.org/10.13037/ras.vol14n47.3391 DOI: https://doi.org/10.13037/ras.vol14n47.3391
Linacre MJ. What do infit and outfit, mean-square and standardized mean? [Internet]. [cited 2024 Sept 3]. Available from: https://rasch.org/rmt/rmt162f.htm
Dabaghi S, Esmaielzadeh F, Rohani C. Application of Rasch analysis for development and psychometric properties of adolescents’ quality of life instruments: a systematic review. Adolesc Health Med Ther. 2020;11:173–97. https://doi.org/10.2147/AHMT.S265413 DOI: https://doi.org/10.2147/AHMT.S265413
Slade GD. Derivation and validation of a short-form oral health impact profile. Community Dent Oral Epidemiol. 1997;25:284–90. https://doi.org/10.1111/j.1600-0528.1997.tb00941.x DOI: https://doi.org/10.1111/j.1600-0528.1997.tb00941.x
Yap AU, Cao Y, Zhang MJ, Lei J, Fu KY. Age-related differences in diagnostic categories, psychological states and oral health-related quality of life of adult temporomandibular disorder patients. J Oral Rehabil. 2021;48:361–8. https://doi.org/10.1111/joor.13121 DOI: https://doi.org/10.1111/joor.13121
Zafar MS, Fareed WM, Taymour N, Khurshid Z, Khan AH. Self-reported frequency of temporomandibular disorders among undergraduate students at Taibah University. J Taibah Univ Med Sci. 2017;12:517–22. https://doi.org/10.1016/j.jtumed.2016.12.004 DOI: https://doi.org/10.1016/j.jtumed.2016.12.004
Habib SR, Al Rifaiy MQ, Awan KH, Alsaif A, Alshalan A, Altokais Y. Prevalence and severity of temporomandibular disorders among university students in Riyadh. Saudi Dent J. 2015;27:125–30. https://doi.org/10.1016/j.sdentj.2014.11.009 DOI: https://doi.org/10.1016/j.sdentj.2014.11.009
Friedman MH, Nelson AJ. Head and neck pain review: traditional and new perspectives. J Orthop Sports Phys Ther. 1996;24:268–78. https://doi.org/10.2519/jospt.1996.24.4.268 DOI: https://doi.org/10.2519/jospt.1996.24.4.268
Hasvold T, Johnsen R, Førde OH. Non-migrainous headache, neck or shoulder pain, and migraine – differences in association with background factors in a city population. Scand J Prim Health Care. 1996;14:92–9. https://doi.org/10.3109/02813439608997077 DOI: https://doi.org/10.3109/02813439608997077
Jiménez-Silva A, Peña-Durán C, Tobar-Reyes J, Frugone-Zambra R. Sleep and awake bruxism in adults and its relationship with temporomandibular disorders: a systematic review from 2003 to 2014. Acta Odontol Scand. 2017;75:36–58. https://doi.org/10.1080/00016357.2016.1247465 DOI: https://doi.org/10.1080/00016357.2016.1247465
de Oliveira Reis L, Ribeiro RA, Martins CC, Devito KL. Association between bruxism and temporomandibular disorders in children: a systematic review and meta-analysis. Int J Paediatr Dent. 2019;29:585–59. https://doi.org/10.1111/ipd.12496 DOI: https://doi.org/10.1111/ipd.12496
Manfredini D, Lombardo L, Siciliani G. Temporomandibular disorders and dental occlusion. A systematic review of association studies: end of an era? J Oral Rehabil. 2017;44:908–23. https://doi.org/10.1111/joor.12531 DOI: https://doi.org/10.1111/joor.12531
Lozano Rojas OM, Rojas Tejada AJ, Pérez Meléndez C. Development of a specific health-related quality of life test in drug abusers using the Rasch rating scale model. Eur Addict Res. 2009;15:63–70. https://doi.org/10.1159/000189784 DOI: https://doi.org/10.1159/000189784
Wong HM, McGrath CP, King NM. Rasch validation of the early childhood oral health impact scale. Community Dent Oral Epidemiol. 2011;39:449–57. https://doi.org/10.1111/j.1600-0528.2011.00614.x DOI: https://doi.org/10.1111/j.1600-0528.2011.00614.x
Prieto L, Alonso J, Lamarca R. Classical test theory versus Rasch analysis for quality of life questionnaire reduction. Health Qual Life Outcomes. 2003;1:27. https://doi.org/10.1186/1477-7525-1-27 DOI: https://doi.org/10.1186/1477-7525-1-27
Rilo B, Fernández-Formoso N, Mora MJ, Cadarso-Suárez C, Santana U. Distance of the contact glide in the closing masticatory stroke during mastication of three types of food. J Oral Rehabil. 2009;36:571–6. https://doi.org/10.1111/j.1365-2842.2009.01956.x DOI: https://doi.org/10.1111/j.1365-2842.2009.01956.x
Mogil JS, Bailey AL. Sex and gender differences in pain and analgesia. Prog Brain Res. 2010;186:141–57. https://doi.org/10.1016/B978-0-444-53630-3.00009-9 DOI: https://doi.org/10.1016/B978-0-444-53630-3.00009-9
Althubaiti A. Information bias in health research: definition, pitfalls, and adjustment methods. J Multidiscip Healthc. 2016;9:211–17. https://doi.org/10.2147/JMDH.S104807 DOI: https://doi.org/10.2147/JMDH.S104807
Additional Files
Published
Issue
Section
License
Copyright (c) 2025 Adrian Ujin Yap, Indrayadi Gunardi, Darren Zong Ru Lee, Carolina Marpaung
This work is licensed under a Creative Commons Attribution 4.0 International License.
Acta Odontologica Scandinavica publishes original research papers as well as critical reviews relevant to the diagnosis, epidemiology, health service, prevention, aetiology, pathogenesis, pathology, physiology, microbiology, development and treatment of diseases affecting tissues of the oral cavity and associated structures including papers on cause and effect or explanatory/associative relationships for experimental or observational studies.
