Abstract：
OBJECTIVE: The aim of this study was to validate the Neuropathic Pain for Post-Surgical Patients (NeuPPS) scale against clinically verified neuropathic pain (NP) by quantitative sensory testing (QST) as well as evaluation of other psychometric properties. The NeuPPS is a validated 5-item scale designed to evaluate NP in surgical populations.
METHODS: Data from 537 women aged >18 years scheduled for primary breast cancer surgery enrolled in a previous study for assessing risk factors for persistent pain after breast cancer treatment were used. Exclusion criteria were any other breast surgery or relevant comorbidity. A total of 448 eligible questionnaires were available at 6 months and 455 at 12 months. At 12 months, 290 patients completed a clinical examination and QST. NeuPPS and PainDETECT were analyzed against patients with and without clinically verified NP. NP was assessed using a standardized QST protocol including a clinical assessment. Furthermore, the NeuPPS and PainDETECT scores were psychometrically tested with an item response theory method, the Rasch analysis, to assess construct validity. Primary outcomes were the diagnostic accuracy measures for the NeuPPS, and secondary measures were psychometric analyses of the NeuPPS after 6 and 12 months. PainDETECT was also compared to clinically verified NP as well as NeuPPS comparing the stability of the estimates.
RESULTS: Comparing the NeuPPS scores with verified NP using a receiver operating characteristic curve, the NeuPPS had an area under the curve of 0.80. Using a cutoff of 1, the NeuPPS had a sensitivity of 88% and a specificity of 59%, and using a cutoff of 3, the values were 35 and 96%, respectively. Analysis of the PainDETECT indicated that the used cutoffs may be inappropriate in a surgical population.
CONCLUSIONS: The present study supports the validity of the NeuPPS as a screening tool for NP in a surgical population.
METHODS: Data from 537 women aged >18 years scheduled for primary breast cancer surgery enrolled in a previous study for assessing risk factors for persistent pain after breast cancer treatment were used. Exclusion criteria were any other breast surgery or relevant comorbidity. A total of 448 eligible questionnaires were available at 6 months and 455 at 12 months. At 12 months, 290 patients completed a clinical examination and QST. NeuPPS and PainDETECT were analyzed against patients with and without clinically verified NP. NP was assessed using a standardized QST protocol including a clinical assessment. Furthermore, the NeuPPS and PainDETECT scores were psychometrically tested with an item response theory method, the Rasch analysis, to assess construct validity. Primary outcomes were the diagnostic accuracy measures for the NeuPPS, and secondary measures were psychometric analyses of the NeuPPS after 6 and 12 months. PainDETECT was also compared to clinically verified NP as well as NeuPPS comparing the stability of the estimates.
RESULTS: Comparing the NeuPPS scores with verified NP using a receiver operating characteristic curve, the NeuPPS had an area under the curve of 0.80. Using a cutoff of 1, the NeuPPS had a sensitivity of 88% and a specificity of 59%, and using a cutoff of 3, the values were 35 and 96%, respectively. Analysis of the PainDETECT indicated that the used cutoffs may be inappropriate in a surgical population.
CONCLUSIONS: The present study supports the validity of the NeuPPS as a screening tool for NP in a surgical population.
摘要：
目的：这项研究的目的是通过定量感觉测试（QST）以及评估其他心理测量特性，验证手术后患者的神经性疼痛（NeuPPS）量表与临床验证的神经性疼痛（NP）。NeuPPS是经过验证的5项量表，旨在评估手术人群中的NP。
方法：使用了537名年龄>18岁的原发性乳腺癌手术患者的数据，该研究纳入了先前的一项研究，用于评估乳腺癌治疗后持续性疼痛的危险因素。排除标准是任何其他乳房手术或相关合并症。6个月时共有448份合格问卷，12个月时共有455份。12个月时,290例患者完成了临床检查和QST。针对有和没有临床证实的NP的患者分析了NeuPPS和PainDETECT。使用包括临床评估的标准化QST方案评估NP。此外，NeuPPS和PainDETECT分数用项目反应理论方法进行了心理测试，Rasch分析,评估结构效度。主要结果是NeuPPS的诊断准确性指标，次要措施是在6个月和12个月后对NeuPPS进行心理测量分析。还将PainDETECT与临床验证的NP以及NeuPPS进行比较,比较估计的稳定性。
结果：使用受试者工作特征曲线将NeuPPS评分与已验证的NP进行比较，NeuPPS的曲线下面积为0.80。使用1的截止值，NeuPPS的灵敏度为88％，特异性为59％，使用3的临界值，该值分别为35％和96％，分别。对PainDETECT的分析表明，在手术人群中使用的截止值可能不合适。
结论：本研究支持NeuPPS在手术人群中作为NP筛选工具的有效性。
方法：使用了537名年龄>18岁的原发性乳腺癌手术患者的数据，该研究纳入了先前的一项研究，用于评估乳腺癌治疗后持续性疼痛的危险因素。排除标准是任何其他乳房手术或相关合并症。6个月时共有448份合格问卷，12个月时共有455份。12个月时,290例患者完成了临床检查和QST。针对有和没有临床证实的NP的患者分析了NeuPPS和PainDETECT。使用包括临床评估的标准化QST方案评估NP。此外，NeuPPS和PainDETECT分数用项目反应理论方法进行了心理测试，Rasch分析,评估结构效度。主要结果是NeuPPS的诊断准确性指标，次要措施是在6个月和12个月后对NeuPPS进行心理测量分析。还将PainDETECT与临床验证的NP以及NeuPPS进行比较,比较估计的稳定性。
结果：使用受试者工作特征曲线将NeuPPS评分与已验证的NP进行比较，NeuPPS的曲线下面积为0.80。使用1的截止值，NeuPPS的灵敏度为88％，特异性为59％，使用3的临界值，该值分别为35％和96％，分别。对PainDETECT的分析表明，在手术人群中使用的截止值可能不合适。
结论：本研究支持NeuPPS在手术人群中作为NP筛选工具的有效性。
