National Center of Epidemiology, Carlos III Institute of Health, Madrid, Spain.
Center for Networked Biomedical Research in Neurodegenerative Diseases (CIBERNED), Carlos III Institute of Health, Madrid, Spain.
Eur J Neurol. 2018 Oct;25(10):1255-1261. doi: 10.1111/ene.13691. Epub 2018 Jun 22.
Pain is highly prevalent in Parkinson's disease (PD), impacting patients' ability, mood and quality of life. Detecting the presence of pain in its multiple modalities is necessary for adequate personalized management of PD. A 14-item, PD-specific, patient-based questionnaire (the King's Parkinson's Disease Pain Questionnaire, KPPQ) was designed corresponding to the rater-based KPP Scale (KPPS). The present multicentre study was aimed at testing the validity of this screening tool.
First, a comparison between the KPPQ scores of patients and matched controls was performed. Next, convergent validity, reproducibility (test-retest) and diagnostic performance of the questionnaire were analysed.
Data from 300 patients and 150 controls are reported. PD patients declared significantly more pain symptoms than controls (3.96 ± 2.56 vs. 2.17 ± 1.39; P < 0.0001). The KPPQ convergent validity was high with KPPS total score (r = 0.80) but weak or moderate with other pain assessments. Test-retest reliability was satisfactory with kappa values ≥0.65 except for item 5, Dyskinetic pains (κ = 0.44), and the intraclass correlation coefficient (ICC) for the KPPQ total score was 0.98. After the scores of the KPPS were adapted for screening (0, no symptom; ≥1, symptom present), a good agreement was found between the KPPQ and the KPPS (ICC = 0.88). A strong correlation (r = 0.80) between the two instruments was found. The diagnostic parameters of the KPPQ were very satisfactory as a whole, with a global accuracy of 78.3%-98.3%.
These results suggest that the KPPQ is a useful, reliable and valid screening instrument for pain in PD to advance patient-related outcomes.
疼痛在帕金森病（PD）中非常普遍，影响患者的能力、情绪和生活质量。为了对 PD 进行充分的个性化管理，有必要对疼痛的多种模式进行检测。为此设计了一种 14 项、基于患者的、针对 PD 的问卷（帕金森病疼痛问卷，KPPQ），与基于评定者的 KPP 量表（KPPS）相对应。本多中心研究旨在检验该筛查工具的有效性。
首先，比较了患者和匹配对照者的 KPPQ 评分。其次，分析了问卷的相关性、可重复性（测试-重测）和诊断性能。
报告了 300 名患者和 150 名对照者的数据。PD 患者报告的疼痛症状明显多于对照组（3.96±2.56 比 2.17±1.39；P<0.0001）。KPPQ 与 KPPS 总分的相关性很高（r=0.80），但与其他疼痛评估的相关性较弱或中等。除了第 5 项（运动障碍性疼痛，κ=0.44）外，KPPQ 的测试-重测信度良好，kappa 值≥0.65，KPPQ 总分的组内相关系数（ICC）为 0.98。适应 KPPS 评分用于筛查（0，无症状；≥1，症状存在）后，KPPQ 与 KPPS 之间有较好的一致性（ICC=0.88）。这两种仪器之间存在较强的相关性（r=0.80）。KPPQ 的整体诊断参数非常令人满意，总体准确性为 78.3%-98.3%。
这些结果表明，KPPQ 是一种有用、可靠和有效的 PD 疼痛筛查工具，可提高患者相关结局。
