An investigation of machine learning algorithms for prediction of temporomandibular disorders by using clinical parameters

This study aimed to predict temporomandibular disorder (TMD) using machine learning (ML) approaches based on measurement parameters that are practically acquired in clinical settings. 125 patients with TMD and 103 individuals without TMD were included in the study. Pain intensity (with visual analog scale), maximum mouth opening (MMO) and lateral excursion movements (with millimeter ruler), cervical range of motion (with goniometer), pressure pain threshold (PPT; with algometer), oral parafunctional behaviors (with Oral Behaviors Checklist), psychological status (with Hospital Anxiety and Depression Scale), and quality of life (with Oral Health Impact Profile) were evaluated. The measurements were analyzed via over 20 ML algorithms, taking into account an extensive parameter tuning and cross-validation process. Results of variable importance were also provided. Bagging algorithm using Multivariate Adaptive Regression Spline (MARS) algorithm (accuracy = 0.8966, area under receiver operating characteristic curve = 0.9387, F1-score = 0.9032) was the best performing model regarding the performance criteria. According to this model, the 5 most important variables for predicting TMD were pain intensity, MMO, lateral excursion and PPT values of masseter and temporalis anterior muscles, respectively. The Bagging algorithm using the MARS algorithm is a robust model that, in combination with clinical parameters, assists in the detection of patients with TMD in settings with limited capabilities. The clinical parameters and ML algorithm proposed in this study may assist clinicians inexperienced in TMD to make a preliminary detection of TMD in clinics where diagnostic imaging tools are limited.