目的:尽管在鞭打相关疾病(WAD)中已经报道了神经性疼痛(NP)成分的存在,没有研究分析NP筛查问卷在WAD中检测NP成分的有用性.本研究旨在评估三种筛查NP工具(DouleurNeuropathique4[DN4],自我管理的利兹神经性症状和体征评估[S-LANSS],和疼痛检测问卷[PDQ])以检测急性WAD中NP成分的存在。
方法:横断面研究。
方法:医院。
方法:在188名符合条件的个人中,50人(68%为女性,平均年龄=40.3±12.5岁),包括急性WAD(52%III级)。
方法:专业医师最初根据临床实践和国际建议筛选参与者是否存在NP成分。经过医生评估,盲目的研究人员使用NP筛查问卷(DN4,S-LANSS,PDQ)在事故发生后2周内。分析这些工具的诊断准确性,并与参考标准(医师评估)进行比较。
结果::三个筛选问卷显示出优异的判别效度(曲线下面积[AUC]≥0.8),尤其是S-LANSS(AUC:0.9;p<0.001)。DN4表现出最高的灵敏度(87%),其次是S-LANSS(75%),而S-LANSS和PDQ表现出最高的特异性(85%和82%,分别)。这些工具证明与参考标准有很强的相关性(S-LANSS:Rho=0.7;PDQ:Rho=0.62;DN4:Rho=0.7;所有,p<0.001)。
结论:DN4,S-LANSS和PDQ对检测急性WAD中NP成分的存在具有良好的判别有效性,尤其是S-LANSS.使用这些工具进行初步筛查可能会改善WAD的管理。
OBJECTIVE: Although the presence of neuropathic pain (NP) components has been reported in whiplash-associated disorders (WAD), no studies have analyzed the usefulness of NP screening questionnaires to detect NP components in WAD. This study aimed to assess the usefulness of 3 NP screening tools (Douleur Neuropathique 4 [DN4], self-administered Leeds Assessment of Neuropathic Symptoms and Signs [S-LANSS], and painDETECT questionnaire [PDQ]) to detect the presence of NP components in acute WAD.
METHODS: A cross-sectional study.
METHODS: Hospital.
METHODS: Of 188 eligible individuals, 50 people (68% women, mean age = 40.3 ± 12.5 years) with acute WAD (52% Grade III) were included.
METHODS: Specialized physicians initially screened participants for the presence of NP components according to clinical practice and international recommendations. After physician assessment, blinded investigators used NP screening questionnaires (DN4, S-LANSS, and PDQ) to assess participants within 2 weeks of their accident. The diagnostic accuracy of these tools was analyzed and compared with the reference standard (physicians\' assessments).
RESULTS: The 3 screening questionnaires showed excellent discriminant validity (area under the curve: ≥0.8), especially S-LANSS (area under the curve: 0.9; P < .001). DN4 demonstrated the highest sensitivity (87%), followed by S-LANSS (75%), while S-LANSS and PDQ showed the highest specificity (85% and 82%, respectively). These tools demonstrated a strong correlation with the reference standard (S-LANSS: rho = 0.7; PDQ: rho = 0.62; DN4: rho = 0.7; all, P < .001).
CONCLUSIONS: The DN4, S-LANSS, and PDQ show excellent discriminant validity to detect the presence of NP components in acute WAD, especially S-LANSS. Initial screening with these tools might improve management of WAD.