Development, validity, and reliability of the band and loop radiographic assessment scoring system (BRASS)

The purpose of this study was to develop a radiographic evaluation scale which, when combined with clinical criteria, could help reduce the failure rate of the conventional band and loop (CBL) space maintainer.

The Band and Loop Radiographic Assessment Scoring System (BRASS) was developed following best practices for scale development in healthcare. The process began with data collection through a literature review, followed by face and content validity assessment of the items generated using the sum-score decision rule and content validity ratio. Pre-testing of the scale was conducted through item-total correlation and factor analysis using the Tucker-Lewis Index, which facilitated item reduction. Pilot testing of the scale was subsequently carried out, and test-retest reliability, predictive validity, and two measures of construct validity were evaluated.

The initial pool of 20 items was reduced to 10, distributed across three criteria based on the results of the goodness-of-fit test. The mean accuracy of the scale, based on predictive validity, was 89%. Test-retest reliability, measured by Cronbach's Alpha, was 0.87. Construct validity revealed a significant difference (p less than 0.05) in evaluations conducted with and without the use of BRASS. Finally, multiple linear regression analysis indicated a strong model fit (R-squared = 0.991), further supporting the construct validity of the BRASS.

The development of BRASS, supported by strong validity and reliability metrics, presents it as a promising tool to enhance the clinical success of the conventional band and loop (CBL) space maintainer.