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Clinical Trials in TMD Sections
Author Bio
Introduction
The Biopsychosocial Model
Designing Multicenter RCTs
Players in an RCT
Randomization
Trial Design Quality
TMD Case Definition
Endpoints and Outcome Measures
Blinding & Masking
Study Sample Size
Number and Nature of Interventions
Currently selected section: Study Length and Follow up
Intent-to-treat Analyses and Sample Size
Compliance
Multicenter RCTs
Implementing RCTs: Practical Issues
Analysis of TMD Trials
Conclusions
Acknowledgments
Appendix A
Appendix B

 

Chapter 22: Clinical Trials in Temporomandibular: Study Length and Follow up
          

Follow up Trajectories

In longitudinal epidemiologic studies of the course of TMD symptoms, it was observed that at any particular follow up period, there were TMD patients who showed improvement and some not. But the course of improvement in TMD-related pain showed a myriad of trajectories (Ohrbach and Dworkin, 1998):

  • Some patients alternated between improvement and relapse
  • Others showed immediate and sustained improvement over a five-year period
  • Still others showed more gradual improvement over the 5-year course of the study

The three trajectories that TMD pain followed over a 5-year period are illustrated in Figure 12.3a, Figure 12.3b, and Figure 12.3c. These data again support use of longer follow up periods of at least a year after the end of TMD treatment.

Figure 12.3a Variable Course of TMD Pain Over 5 Years: Pain Pattern 1
40.6% of TMD Cases (n=236) Baseline - 5 Year Follow up
Graphic depiction showing immediate and sustained improvement over a five-year period, described in text.

Figure 12.3b Variable Course of TMD Pain Over 5 Years: Pain Pattern 2
10.6% of TMD Cases (n=236) Baseline - 5 Year Follow up
Graphic depiction showing more gradual improvement over the 5-year course of the study, described in text.

Figure 12.3c Variable Course of TMD Pain Over 5 Years: Pain Pattern 3
9.4% of TMD Cases (n=236) Baseline - 5 Year Follow up
Graphic depiction showing that some patients alternated between improvement and relapse, described in text.

 

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