Rehabilitation Science Postgraduate Program at Augusto Motta University Centre (UNISUAM), Rio de Janeiro, Brazil.
Rehabilitation Science Postgraduate Program at Augusto Motta University Centre (UNISUAM), Rio de Janeiro, Brazil.
Joint Bone Spine. 2021 May;88(3):105127. doi: 10.1016/j.jbspin.2020.105127. Epub 2021 Jan 30.
The current study aimed to evaluate the concurrent validity and the diagnostic accuracy of the Central Sensitization Inventory (CSI) in detecting the impairment of the pain modulation in patients with chronic musculoskeletal pain.
A cross-sectional study was conducted in 267 patients with chronic musculoskeletal pain enrolled consecutively in an outpatient department. The CSI (index method) were compared with the cold pressor test, which was the psychophysical test used to assess the conditioned pain modulation (CPM), (reference standard). Spearman's correlations assessed the concurrent validity, and measurements of the diagnostic accuracy were performed.
Ninety-three (34.8%) patients had CSI scores≥40. No significant correlation was found between CSI findings and the results of the CPT (dorsal forearm site or tibialis anterior site) was found. The cutoff point of 40 of the CSI showed values of sensitivity (35.1%, 95% CI: 22.6, 49.3) and specificity (65.2%, 95% CI: 58.4, 71.6) below 70%, and an accuracy of 59.1 (95% CI: 53.0, 65.1) when compared to the CPT to detect deficit. The ROC curve analysis yielded an area under the curve of 0.54 (95% CI: 0.45, 0.63, P>0.05).
The CSI is a useless instrument to detect the deficit in the CPM in patients with chronic musculoskeletal pain due to the absence of correlation with the psychophysical test result and the insufficient measurements of diagnostic accuracy.
本研究旨在评估中枢敏化量表（CSI）在检测慢性肌肉骨骼疼痛患者疼痛调节受损中的同时效度和诊断准确性。
这是一项横断面研究，连续纳入 267 例慢性肌肉骨骼疼痛患者。将 CSI（指标方法）与冷加压测试（CPT）进行比较，CPT 是评估条件疼痛调制（CPM）的心理物理测试（参考标准）。采用 Spearman 相关评估同时效度，并进行诊断准确性的测量。
93 例（34.8%）患者的 CSI 评分≥40。CSI 结果与 CPT（背侧前臂或胫骨前肌部位）结果之间未发现显著相关性。CSI 的截断值为 40 时，其敏感性（22.6%，95%CI：22.6%，49.3%）和特异性（65.2%，95%CI：58.4%，71.6%）均低于 70%，与 CPT 相比，检测到缺陷的准确性为 59.1%（95%CI：53.0%，65.1%）。ROC 曲线分析得出曲线下面积为 0.54（95%CI：0.45，0.63，P>0.05）。
由于 CSI 与心理物理测试结果无相关性，且诊断准确性测量不足，因此 CSI 是一种无用的工具，无法检测慢性肌肉骨骼疼痛患者 CPM 缺陷。
