Department of Obstetrics and Gynecology, University of Rochester School of Medicine and Dentistry, Rochester, New York.
J Minim Invasive Gynecol. 2011 Mar-Apr;18(2):211-7. doi: 10.1016/j.jmig.2010.12.009.
To estimate the usefulness of the Short-Form McGill Pain Questionnaire (MPQ) pain descriptors in the diagnostic evaluation of chronic pelvic pain.
Retrospective cohort study (Canadian Task Force classification II-2).
University-based center specializing in chronic pelvic pain.
Three hundred thirty-one consecutively evaluated women with chronic pelvic pain who had data sufficient for evaluation.
The relationships between MPQ pain descriptors and subsequent diagnoses were evaluated using odds ratios, sensitivity, specificity, and positive and negative predictive values.
The most common diagnoses were endometriosis, interstitial cystitis and painful bladder syndrome, and irritable bowel syndrome. Seventy-one percent of the patients had more than one diagnosis. Relative risks for pain descriptors as diagnostic tools for specific diagnoses were most significant, with "cramping" for endometriosis (4.0), "cramping" for interstitial cystitis and painful bladder syndrome (2.0), "sickening" for irritable bowel syndrome (1.5), and "aching" for abdominal myofascial pain syndrome (4.27).
Several of the MPQ descriptors had high negative predictive values but not high positive predictive values, which suggests that they have diagnostic usefulness in excluding but not predicting pelvic pain-related diagnoses. This was especially the case with cramping as an MPQ descriptor in women with endometriosis. However, overall the MPQ descriptors were not robust as diagnostic tools, which suggests that inclusion of the MPQ descriptors in the evaluation of women with chronic pelvic pain is of limited diagnostic value.
评估短式麦吉尔疼痛问卷(MPQ)疼痛描述符在慢性盆腔痛诊断评估中的有用性。
回顾性队列研究(加拿大任务组分类 II-2)。
专门研究慢性盆腔痛的大学中心。
331 例连续评估的慢性盆腔痛女性,其数据足以进行评估。
使用比值比、敏感性、特异性、阳性和阴性预测值评估 MPQ 疼痛描述符与后续诊断之间的关系。
最常见的诊断是子宫内膜异位症、间质性膀胱炎和膀胱疼痛综合征以及肠易激综合征。71%的患者有不止一种诊断。疼痛描述符作为特定诊断的诊断工具的相对风险最大,“痉挛”与子宫内膜异位症相关(4.0),“痉挛”与间质性膀胱炎和膀胱疼痛综合征相关(2.0),“恶心”与肠易激综合征相关(1.5),“酸痛”与腹肌筋膜疼痛综合征相关(4.27)。
MPQ 描述符中的几个具有较高的阴性预测值,但阳性预测值不高,这表明它们在排除但不能预测与盆腔疼痛相关的诊断方面具有诊断有用性。这在子宫内膜异位症女性中尤其如此,“痉挛”是 MPQ 描述符之一。然而,总体而言,MPQ 描述符作为诊断工具并不稳健,这表明在评估慢性盆腔痛女性时,包括 MPQ 描述符的评估在诊断方面的价值有限。