Diagnostic accuracy of an identification tool for localized neuropathic pain based on the IASP criteria
| Autor: | Jesús Villoria, Concepción Pérez-Hernández, Victor Mayoral, Ana Leal, Ana Esquivias, Inmaculada Muro |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty business.industry Diagnostic accuracy General Medicine Middle Aged 03 medical and health sciences Identification (information) 0302 clinical medicine Pain Clinics Physical medicine and rehabilitation Case-Control Studies Neuropathic pain Medicine Humans Neuralgia Female 030212 general & internal medicine business 030217 neurology & neurosurgery Aged |
| Zdroj: | Current medical research and opinion. 34(8) |
| ISSN: | 1473-4877 |
| Popis: | Based on the clear neuroanatomical delineation of many neuropathic pain (NP) symptoms, a simple tool for performing a short structured clinical encounter based on the IASP diagnostic criteria was developed to identify NP. This study evaluated its accuracy and usefulness.A case-control study was performed in 19 pain clinics within Spain. A pain clinician used the experimental screening tool (the index test, IT) to assign the descriptions of non-neuropathic (nNP), non-localized neuropathic (nLNP), and localized neuropathic (LNP) to the patients' pain conditions. The reference standard was a formal clinical diagnosis provided by another pain clinician. The accuracy of the IT was compared with that of the Douleur Neuropathique en 4 questions (DN4) and the Leeds Assessment of Neuropathic Signs and Symptoms (LANSS).Six-hundred and sixty-six patients were analyzed. There was a good agreement between the IT and the reference standard (kappa =0.722). The IT was accurate in distinguishing between LNP and nLNP (83.2% sensitivity, 88.2% specificity), between LNP and the other pain categories (nLNP + nNP) (80.0% sensitivity, 90.7% specificity), and between NP and nNP (95.5% sensitivity, 89.1% specificity). The accuracy in distinguishing between NP and nNP was comparable with that of the DN4 and the LANSS. The IT took a median of 10 min to complete.A novel instrument based on an operationalization of the IASP criteria can not only discern between LNP and nLNP, but also provide a high level of diagnostic certainty about the presence of NP after a short clinical encounter. |
| Databáze: | OpenAIRE |
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