Mistry Jai, Heneghan Nicola R, Noblet Timothy, Falla Deborah, Rushton Alison
Physiotherapy, St George's Hospital NHS Foundation Trust, London, UK.
Centre of Precision Rehabilitation for Spinal Pain, University of Birmingham, Birmingham, UK.
BMJ Open. 2019 Nov 24;9(11):e033187. doi: 10.1136/bmjopen-2019-033187.
Neuropathic low back-related leg pain (LBLP) can be a challenge to healthcare providers to diagnose and treat. Accurate diagnosis of neuropathic pain is fundamental to ensure appropriate intervention is given. However, to date there is no gold standard to diagnose neuropathic LBLP. Patient examination guidelines and screening tools have been developed and validated for the purpose of diagnosing neuropathic pain in LBLP; however, there has been no systematic review conducted to compare the diagnostic validity of these methods. Therefore, this systematic review will investigate the diagnostic utility of patient history, clinical examination and screening tool data to identify neuropathic pain in LBLP.
This protocol is informed and reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis-Protocols. CINAHL, EMBASE, MEDLINE, Web of Science, Cochrane Library, AMED, Pedro, PubMed, key journals and grey literature will be searched rigorously to find diagnostic accuracy studies investigating patient examination data to identify neuropathic pain in LBLP patients. Two independent reviewers will conduct the search, extract the data and assess risk of bias for included studies using the Quality Assessment of Diagnostic Accuracy Studies 2 tool. The overall quality of included studies will be evaluated using Grading of Recommendations, Assessment, Development and Evaluation guidelines. A meta-analysis will be conducted if deemed appropriate. Otherwise, a narrative synthesis will be conducted.
No research ethics is required for this systematic review since patient data will not be collected. This review will help to inform healthcare professionals and researchers on the most effective means in which to diagnose neuropathic pain in LBLP. Results of this review will be submitted for publication in a peer-review journal and conference presentations.
CRD42019140861.
神经性腰源性腿痛（LBLP）对医疗服务提供者来说在诊断和治疗方面可能是一项挑战。准确诊断神经性疼痛是确保给予适当干预的基础。然而，迄今为止，尚无诊断神经性LBLP的金标准。已经制定并验证了患者检查指南和筛查工具，用于诊断LBLP中的神经性疼痛；然而，尚未进行系统评价来比较这些方法的诊断有效性。因此，本系统评价将研究患者病史、临床检查和筛查工具数据在识别LBLP中神经性疼痛方面的诊断效用。
本方案是根据系统评价和Meta分析方案的首选报告项目制定并报告的。将严格检索CINAHL、EMBASE、MEDLINE、科学网、Cochrane图书馆、AMED、Pedro、PubMed、主要期刊和灰色文献，以查找调查患者检查数据以识别LBLP患者神经性疼痛的诊断准确性研究。两名独立的评审员将进行检索、提取数据，并使用诊断准确性研究质量评估2工具评估纳入研究的偏倚风险。将使用推荐分级、评估、制定和评价指南评估纳入研究的整体质量。如果认为合适，将进行Meta分析。否则，将进行叙述性综合分析。
由于不会收集患者数据，因此本系统评价无需研究伦理。本评价将有助于告知医疗专业人员和研究人员诊断LBLP中神经性疼痛的最有效方法。本评价的结果将提交给同行评审期刊发表并在会议上展示。
PROSPERO注册号：CRD42019140861。
