背景:有神经病样症状的人比有伤害性的人有更多不利的疼痛特征。此外,条件性疼痛调节不足在有神经病样症状的人中很常见。PainDETECT问卷已用于评估中枢致敏体征和症状。然而,painDETECT问卷是否可以识别条件性疼痛调节的损害仍是未知的。因此,本研究旨在评估疼痛检测问卷对肌肉骨骼疼痛患者条件性疼痛调节受损的诊断准确性.
方法:我们进行了一项诊断准确性比较,用于评估条件性疼痛调节的心理物理测试(参考标准)。我们通过计算灵敏度来确定诊断准确性,特异性,预测值,和可能的引擎盖比率。
结果:我们回顾性地纳入了308名门诊肌肉骨骼疼痛患者。大多数参与者是女性(n20=220,71.4%),平均年龄为52.2(±15.0)岁。一百七十三名(56.1%)参与者被归类为伤害性疼痛,69(22.4%)不清楚,66(21.4%)为神经病样症状。根据冷压缩机测试,60名(19.4%)参与者表现出条件性疼痛调节受损。与冷压测试相比,痛苦检测问卷的12个截止点显示诊断准确性低于70%,阴性预测值除外[76.995%置信区间(CI)71.7至81.5]。截止点19显示高特异性(78.6%,95%CI73.0至83.5),高阴性预测值(80.5%,95%CI78.1至82.7),与冷压缩机测试相比,准确率为67.5%。
结论:painDETECT问卷对于排除肌肉骨骼疼痛和条件性疼痛调节受损的患者似乎很有价值。
BACKGROUND: People with neuropathic-like symptoms had more unfavourable pain features than people with nociceptive. Moreover, deficient conditioned pain modulation is common in people with neuropathic-like symptoms. PainDETECT questionnaire have been used to assess the central sensitisation sign and symptoms. However, whether the painDETECT questionnaire can identify the conditioned pain modulation\'s impairment is still unknown. Therefore, the current study aimed to evaluate the diagnostic accuracy of the painDETECT questionnaire in detecting the impairment of conditioned pain modulation in people with musculoskeletal pain.
METHODS: We conducted a diagnostic accuracy comparing the painDETECT questionnaire (index method) with the cold pressor test, the psychophysical test used to assess the conditioned pain modulation (reference standard). We determined diagnostic accuracy by calculating sensitivity, specificity, predictive values, and likely hood ratios.
RESULTS: We retrospectively enrolled 308 people with musculoskeletal pain in outpatient departments. Most participants were female (n 20 = 220, 71.4%) and had a mean age of 52.2 (± 15.0) years. One hundred seventy-three (56.1%) participants were classified as nociceptive pain, 69 (22.4%) as unclear, and 66 (21.4%) as neuropathic-like symptoms. According to the cold pressor test, 60 (19.4%) participants presented impairment of conditioned pain modulation. The cutoff point of 12 of the painDETECT questionnaire showed values of diagnostic accuracy below 70% compared to the cold pressor test, except for a negative predictive value [76.9 95% Confidence Interval (CI) 71.7 to 81.5]. The cutoff point 19 showed high specificity (78.6%, 95% CI 73.0 to 83.5), high negative predictive value (80.5%, 95% CI 78.1 to 82.7), and accuracy of 67.5% compared to the cold pressor test.
CONCLUSIONS: The painDETECT questionnaire seems valuable for ruling out people with musculoskeletal pain and impairment of conditioned pain modulation.