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TFM classification and staging of oral submucous fibrosis: A new proposal
Author(s) -
Arakeri Gururaj,
Thomas Deepak,
Aljabab Abdulsalam S.,
Hunasgi Santosh,
Rai Kirthi Kumar,
Hale Beverley,
Fonseca Felipe Paiva,
Gomez Ricardo Santiago,
Rahimi Siavash,
Merkx Matthias A. W.,
Brennan Peter A.
Publication year - 2018
Publication title -
journal of oral pathology and medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.887
H-Index - 83
eISSN - 1600-0714
pISSN - 0904-2512
DOI - 10.1111/jop.12689
Subject(s) - oral submucous fibrosis , medicine , grading (engineering) , kappa , classification scheme , cohen's kappa , categorization , categorical variable , radiology , artificial intelligence , pathology , statistics , machine learning , computer science , mathematics , civil engineering , geometry , engineering
Background We have evaluated the rationale of existing grading and staging schemes of oral submucous fibrosis ( OSMF ) based on how they are categorized. A novel classification and staging scheme is proposed. Methods A total of 300 OSMF patients were evaluated for agreement between functional, clinical, and histopathological staging. Bilateral biopsies were assessed in 25 patients to evaluate for any differences in histopathological staging of OSMF in the same mouth. Extent of clinician agreement for categorized staging data was evaluated using Cohen's weighted kappa analysis. Cross‐tabulation was performed on categorical grading data to understand the intercorrelation, and the unweighted kappa analysis was used to assess the bilateral grade agreement. Probabilities of less than 0.05 were considered significant. Data were analyzed using SPSS Statistics (version 25.0, IBM , USA ). Results A low agreement was found between all the stages depicting the independent nature of trismus, clinical features, and histopathological components (K = 0.312, 0.167, 0.152 ) in OSMF . Following analysis, a three‐component classification scheme ( TFM classification) was developed that describes the severity of each independently, grouping them using a novel three‐tier staging scheme as a guide to the treatment plan. Conclusion The proposed classification and staging could be useful for effective communication, categorization, and for recording data and prognosis, and for guiding treatment plans. Furthermore, the classification considers OSMF malignant transformation in detail.