Rehabilitation Institute of Chicago, Chicago, IL, USA Vanderbilt University School of Medicine, Nashville, TN, USA VU University Medical Center, Amsterdam, The Netherlands Trauma Related Neuronal Dysfunction Consortium (TREND), Leiden University Medical Center, Leiden, The Netherlands University Medical Center Mainz, Mainz, Germany Leiden University Medical Center, Leiden, The Netherlands University of Erlangen-Nuremberg, Erlangen, Germany Rush University Medical Center, Chicago, IL, USA Stanford University Medical Center, Stanford, CA, USA Reuth Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Pain. 2010 Aug;150(2):268-274. doi: 10.1016/j.pain.2010.04.030. Epub 2010 May 20.
Current IASP diagnostic criteria for CRPS have low specificity, potentially leading to overdiagnosis. This validation study compared current IASP diagnostic criteria for CRPS to proposed new diagnostic criteria (the "Budapest Criteria") regarding diagnostic accuracy. Structured evaluations of CRPS-related signs and symptoms were conducted in 113 CRPS-I and 47 non-CRPS neuropathic pain patients. Discriminating between diagnostic groups based on presence of signs or symptoms meeting IASP criteria showed high diagnostic sensitivity (1.00), but poor specificity (0.41), replicating prior work. In comparison, the Budapest clinical criteria retained the exceptional sensitivity of the IASP criteria (0.99), but greatly improved upon the specificity (0.68). As designed, the Budapest research criteria resulted in the highest specificity (0.79), again replicating prior work. Analyses indicated that inclusion of four distinct CRPS components in the Budapest Criteria contributed to enhanced specificity. Overall, results corroborate the validity of the Budapest Criteria and suggest they improve upon existing IASP diagnostic criteria for CRPS.
目前 IASP 对复杂性区域疼痛综合征的诊断标准特异性较低，可能导致过度诊断。本验证研究比较了目前 IASP 对复杂性区域疼痛综合征的诊断标准与新提出的（“布达佩斯标准”）的新诊断标准，以评估其在诊断准确性方面的差异。对 113 例复杂性区域疼痛综合征 I 型和 47 例非复杂性区域疼痛综合征神经性疼痛患者进行了与复杂性区域疼痛综合征相关的体征和症状的结构化评估。基于符合 IASP 标准的体征或症状存在与否对诊断组进行区分，结果显示高诊断敏感度（1.00），但特异性差（0.41），与先前的研究结果一致。相比之下，布达佩斯临床标准保留了 IASP 标准的优异敏感性（0.99），但特异性得到了极大改善（0.68）。按照设计，布达佩斯研究标准的特异性最高（0.79），再次与先前的研究结果一致。分析表明，在布达佩斯标准中纳入四个不同的复杂性区域疼痛综合征组成部分有助于提高特异性。总体而言，研究结果证实了布达佩斯标准的有效性，并表明其优于现有的 IASP 复杂性区域疼痛综合征诊断标准。
