Avoiding Catch-22
Autor: | Nick T van Dasselaar, Marcel J. Schenkels, Monique A H Steegers, Ewald M. Bronkhorst, Hans Timmerman, Oliver H.G. Wilder-Smith, André Wolff, Frank J P M Huygen, Kris Vissers |
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Přispěvatelé: | Anesthesiology, Critical care, Anesthesiology, Peri-operative and Emergency medicine (CAPE) |
Jazyk: | angličtina |
Rok vydání: | 2018 |
Předmět: |
Male
Neurology Cross-sectional study Clinical assessment Screening tool Disease Neuropathic pain lcsh:RC346-429 PainDETECT questionnaire 0302 clinical medicine Sensitivity Surveys and Questionnaires 030212 general & internal medicine education.field_of_study Chronic pain General Medicine Middle Aged Reliability Low back pain 3. Good health Specificity Female medicine.symptom Chronic Pain Neck shoulder arm pain Research Article Adult medicine.medical_specialty Population Pain Sensitivity and Specificity Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18] Validity 03 medical and health sciences medicine Humans education lcsh:Neurology. Diseases of the nervous system Aged business.industry Gold standard Reproducibility of Results medicine.disease Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10] Cross-Sectional Studies Physical therapy Neuralgia Neurology (clinical) business 030217 neurology & neurosurgery Peripheral nerve damage |
Zdroj: | Timmerman, H, Wolff, A P, Bronkhorst, E M, Wilder-Smith, O H G, Schenkels, M J, van Dasselaar, N T, Huygen, F J P M, Steegers, M A H & Vissers, K C P 2018, ' Avoiding Catch-22 : Validating the PainDETECT in a in a population of patients with chronic pain ', BMC Neurology, vol. 18, no. 1, 91 . https://doi.org/10.1186/s12883-018-1094-4 BMC Neurology, 18, 1, pp. 91 Timmerman, H, Wolff, A P, Bronkhorst, E M, Wilder-Smith, O H G, Schenkels, M J, van Dasselaar, N T, Huygen, F J P M, Steegers, M A H & Vissers, K C P 2018, ' Avoiding Catch-22 : validating the PainDETECT in a in a population of patients with chronic pain ', BMC Neurology, vol. 18, no. 1, pp. 91 . https://doi.org/10.1186/s12883-018-1094-4 BMC Neurology, 18(1). BioMed Central BMC Neurology BMC Neurology, 18, 91 BMC Neurology, Vol 18, Iss 1, Pp 1-14 (2018) BMC NEUROLOGY, 18:91. BioMed Central Ltd. BMC Neurology, 18:91. BioMed Central Ltd. |
ISSN: | 1471-2377 |
DOI: | 10.1186/s12883-018-1094-4 |
Popis: | Background Neuropathic pain is defined as pain caused by a lesion or disease of the somatosensory nervous system and is a major therapeutic challenge. Several screening tools have been developed to help physicians detect patients with neuropathic pain. These have typically been validated in populations pre-stratified for neuropathic pain, leading to a so called “Catch-22 situation:” “a problematic situation for which the only solution is denied by a circumstance inherent in the problem or by a rule”. The validity of screening tools needs to be proven in patients with pain who were not pre-stratified on basis of the target outcome: neuropathic pain or non-neuropathic pain. This study aims to assess the validity of the Dutch PainDETECT (PainDETECT-Dlv) in a large population of patients with chronic pain. Methods A cross-sectional multicentre design was used to assess PainDETECT-Dlv validity. Included where patients with low back pain radiating into the leg(s), patients with neck-shoulder-arm pain and patients with pain due to a suspected peripheral nerve damage. Patients’ pain was classified as having a neuropathic pain component (yes/no) by two experienced physicians (“gold standard”). Physician opinion based on the Grading System was a secondary comparison. Results In total, 291 patients were included. Primary analysis was done on patients where both physicians agreed upon the pain classification (n = 228). Compared to the physician’s classification, PainDETECT-Dlv had a sensitivity of 80% and specificity of 55%, versus the Grading System it achieved 74 and 46%. Conclusion Despite its internal consistency and test-retest reliability the PainDETECT-Dlv is not an effective screening tool for a neuropathic pain component in a population of patients with chronic pain because of its moderate sensitivity and low specificity. Moreover, the indiscriminate use of the PainDETECT-Dlv as a surrogate for clinical assessment should be avoided in daily clinical practice as well as in (clinical-) research. Catch-22 situations in the validation of screening tools can be prevented by not pre-stratifying the patients on basis of the target outcome before inclusion in a validation study for screening instruments. Trial registration The protocol was registered prospectively in the Dutch National Trial Register: NTR 3030. Electronic supplementary material The online version of this article (10.1186/s12883-018-1094-4) contains supplementary material, which is available to authorized users. |
Databáze: | OpenAIRE |
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