Leavitt F
J Psychosom Res. 1985;29(5):495-505. doi: 10.1016/0022-3999(85)90083-2.
The pain reports of 553 patients with low back pain and 347 healthy subjects faking low back pain were compared to determine if pain language can be employed as diagnostic aids in differentiating between clinical groups and groups attempting to feign a clinical condition. The best set of discriminating words correctly identified 90% of the subjects using 18 to 54 words in pain description, and 83% using 4 to 17 words in their pain report. The same pain words were used to categorize 366 new pain cases and 202 new fake cases. Cross-validation shrinkage was 8 and 7% respectively. Effectiveness in discriminating between pain and simulation was increased using selective cut-off scores. Patients in active treatment for back pain whose choice of pain words resemble those of the simulators reported 21% more clinical pain in a follow-up validation study suggesting that an accurate representation of malingering may have been achieved using a simulation research design.
比较了553例腰痛患者和347例假装腰痛的健康受试者的疼痛报告，以确定疼痛语言是否可作为诊断辅助手段，用于区分临床组和试图伪装临床病症的组。最佳的一组区分性词汇在疼痛描述中使用18至54个单词时能正确识别90%的受试者，在疼痛报告中使用4至17个单词时能正确识别83%的受试者。相同的疼痛词汇被用于对366例新的疼痛病例和202例新的假装病例进行分类。交叉验证收缩率分别为8%和7%。使用选择性临界值可提高区分疼痛和伪装的有效性。在一项后续验证研究中，正在接受腰痛积极治疗的患者，其选择的疼痛词汇与伪装者相似，报告的临床疼痛多出21%，这表明使用模拟研究设计可能已实现对诈病的准确表征。
