Epub Department The painDETECT questionnaire was used for neuropathic pain screening. Read More · View Article. Download full-text PDF. Adaptation, validity and reliability of the modified painDETECT questionnaire for patients with subacromial pain Epub Feb 6. Download full-text PDF. The painDETECT questionnaire (PDQ) was originally designed to differentiate between pain phenotypes. For the Rasch analysis questionnaires from patients with RA, PsA and SpA ( per Download ePub.
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Patients and Methods: A total of of outpatients agreed to complete a set of questionnaires, including painDETECT. Results: The mean painDETECT. Keywords: PainDETECT questionnaire, Reliability, Validity, Sensitivity, Specificity , Screening tool, Neuropathic pain, Pain, Clinical assessment. Generating an ePub file take a long time, please be patient. Key Words: PainDETECT, neuropathic pain, knee osteoarthritis, multimodality The PainDETECT questionnaire uses a combination of visual analog scale, body .. where it is permissible to download and share the work provided it is properly cited.
Furthermore, Rasch analysis includes a mathematical reliability measure describing how well an instrument differentiates between groups; patients with different pain phenotypes.
Finally, large variation in the examined population e. Whether an instrument has reliable classification ability, can be further investigated by test-retest, which will give an estimation of the stability [ 20 ].
Pain phenotypes are as such not expected to alter, thus the classification thereof should be consistent. Estimation of intraclass correlation coefficients based on exact scores can further support reliablity.
Specifically, to conduct Rasch analysis, including reliability analysis of pain classification by means of person and item distinction in a sample of patients representing all diagnoses, both genders and every degree of activity of the disease. Further, to explore the agreement of scores and the stability of pain classification by test-retest. The registry also includes data on patients treated with synthetic disease-modifying antirheumatic drugs DMARDs.
Before routine clinical control of the arthritic condition, the patients regularly complete diagnosis specific patient reported outcomes on the DANBIO touch screens in the doctors waiting room. The rheumatologist registers corresponding objective clinical outcomes, hence common rheumatologic disease activity measures such as the disease activity score joints DAS28 [ 25 , 26 ] and ankylosing spondylitis disease activity score ASDAS [ 27 ] are available.
These scores are composite scores including subjective and objective parameters of level of inflammatory activity and global health and thus describe the current degree of activity of the specific disease.
Participants To be eligible for inclusion in the Rasch analysis the PDQ had to be complete and originate from a patient who had a disease activity score registered on the same day as the questionnaire was completed. Given the very large sample, we were able to include questionnaires from patients with different degrees of disease activity.
Seeking to ensure generalizability, it was decided that: 1 the extraction of questionnaires should be stratified in thirds according to three disease activity categories low, moderate and high defined by DAS28 or ASDAS, and 2 there should be an equal distribution of gender within the single diagnosis and disease activity category. In cases where both scores were reported, the highest score defined the disease activity category. These criteria restricted the sample, primarily because of the relatively low number of patients having a high disease activity score 53 women with SpA had a high ASDAS , which led to the final extraction procedure: for each diagnosis within each disease activity category, complete questionnaires from the first 50 female respondents and the first 50 male respondents were included.
In all, a sample of questionnaires from participants with either of the diagnoses RA, PsA, SpA and of each gender was compiled.
The PDQ comprises 12 items.
The fourth item includes a chart representation of four pain course patterns depicting persistence, fluctuation and attacks; the patients have to choose the one resembling their pain pattern the most. The remaining seven questions regarding the presence and severity of somatosensory signs and symptoms are rated on a six-category Likert scale from never 0 to very strongly 5 : 1 burning sensation in the painful areas, 2 tingling or prickling in areas of pain, 3 light touching is painful, 4 sudden pain attacks in areas of pain, 5 cold or heat is occasionally painful, 6 numbness in the painful areas, 7 slight pressure triggers pain [ 9 , 14 ].
Pain intensity ratings are not included in the total score. SAS software version 9. Rasch analysis Seven of the nine PDQ questions which contribute to the scoring algorithm were included in the Rasch analysis. This was because: 1 the majority of points achievable on the scoring algorithm, 35 out of 38, originate from these questions, and 2 the scoring of the remaining two elements of the PDQ does not have a character applicable to Rasch analysis [ 19 ].
The item that assesses pain course consists of four different patterns. The item of presence of pain radiation is dichotomous and has a score of either 0 or 2.
Thus, neither of the scorings of these two items can logically be converted into an ordinal scale. This was not taken into consideration in the original development of the questionnaire as Rasch analysis was not performed [ 9 ].
Furthermore, it has been demonstrated by Moreton et al. Statistics evaluating aspects of validity and reliability were generated, including fit of the data to the Rasch model assertions [ 23 , 32 ]. The measures of severity of neuropathic pain symptoms and the item difficulty measures are expressed in logits log-odds probability units [ 33 ]. Rasch analysis procedures have been described in detail elsewhere [23, 32, 34], hence our description of the Rasch method used is brief.
It was decided that the partial credit model PCM [ 35 ] would be used should the data not fulfil the criteria for the rating scale model RSM. Both models are used with polytomous data i. They were able to use paracetamol acetaminophen for analgesia if required during this washout period but were asked to refrain from its use for 12 hours before testing. Self-report Questionnaires PainDETECT is a validated self-report tool with good internal consistency and high sensitivity and specificity that has been used to identify neuropathic pain features in a range of conditions.
Three pain subscores are then calculated 18 : paroxysmal, surface, and deep.
The questionnaire has demonstrated good reliability and excellent internal consistency for all of the subscales. This OA-specific self-report scale has been widely used to measure pain and disability from knee OA, demonstrating good internal validity and test-retest reliability.
Physical Function Tests The aggregated locomotor function ALF test 19 was used as a measure of observed locomotor function. Order of testing was randomized between QST modalities and between test sites.
Pressure pain threshold PPT was assessed using an electronic digital pressure algometer Somedic AB, Sweden , a device with good test-retest reliability. Participants were instructed to press the hand-held switch as soon as the sensation of pressure became one of painful pressure.
CDT was always measured first. Participants were instructed to press the hand-held switch as soon as they perceived any cooling change from baseline. For CPT, participants were instructed to press the switch as soon as the cooling sensation changed to one of painful cold.
Higher CPT values indicate increased cold pain sensitivity. Lower HPT values indicate increased heat pain sensitivity. Data were evaluated to determine if they met the assumption of normality using the Shapiro-Wilk test.
Data that were not normally distributed were analyzed using the nonparametric independent samples Kruskal-Wallis test and the Mann-Witney U test.