Kuhlmann Louise, Teo Keith, Olesen Søren Schou, Phillips Anna Edwards, Faghih Mahya, Tuck Natalie, Afghani Elham, Singh Vikesh K, Yadav Dhiraj, Windsor John A, Drewes Asbjørn Mohr
Centre for Pancreatic Diseases & Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark; Department of Internal Medicine, Randers Regional Hospital, Randers, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
Department of Surgery, School of Medicine, Faculty of Medicine and Health Science, University of Auckland, New Zealand.
Clin Gastroenterol Hepatol. 2022 Apr;20(4):e770-e783. doi: 10.1016/j.cgh.2021.05.055. Epub 2021 Jun 2.
BACKGROUND & AIMS: Pain is the foremost complication to chronic pancreatitis (CP), but no validated questionnaires for assessment exist. The COMPAT questionnaire includes all relevant pain dimensions in CP, but a short form is needed to make it usable in clinical practice.
The full COMPAT questionnaire was completed by 91 patients and systematically reduced to 6 questions. Pain severity and analgesic use were merged, leaving 5 pain dimensions. The pain dimension ratings were normalized to a 0-100 scale, and the weighted total score was calculated, where 3 dimensions were weighted double. Reliability of the short form was tested in a test-retest study in 76 patients, and concurrent validity tested against the Brief Pain Inventory and Izbicki pain questionnaire. Convergent validity was verified using confirmatory factor analysis, and criterion validity tested against quality-of-life and hospitalization rates.
The COMPAT-SF questionnaire consisted of the following pain dimensions: a) pain severity, b) pain pattern, c) factors provoking pain, d) widespread pain, and e) a qualitative pain-describing dimension. Quality of life correlated with the total score and all pain dimensions (P <.05). The total score, pain severity, pain pattern, and factors provoking pain were correlated with hospitalization rates (P <.05). The total score correlated with the Izbicki and Brief Pain Inventory scores (P <.0001). The reliability of the questionnaire in patients in a stable phase was good with an interclass correlation coefficient of 0.89.
The COMPAT-SF questionnaire includes the most relevant aspects of pain in CP and is a feasible, reliable, and valid pain assessment instrument recommended to be used in future trials.
疼痛是慢性胰腺炎(CP)最主要的并发症,但目前尚无经过验证的评估问卷。COMPAT问卷涵盖了CP中所有相关的疼痛维度,但需要一个简短形式以便在临床实践中使用。
91例患者完成了完整的COMPAT问卷,并系统地缩减为6个问题。将疼痛严重程度和镇痛药物使用情况合并,剩下5个疼痛维度。将疼痛维度评分标准化为0 - 100分制,并计算加权总分,其中3个维度的权重加倍。在76例患者的重测研究中测试了简短形式的信度,并与简明疼痛量表和伊兹比基疼痛问卷进行了同时效度测试。使用验证性因素分析验证了收敛效度,并根据生活质量和住院率测试了效标效度。
COMPAT - SF问卷包括以下疼痛维度:a)疼痛严重程度,b)疼痛模式,c)诱发疼痛的因素,d)广泛性疼痛,e)一个描述疼痛性质的维度。生活质量与总分及所有疼痛维度相关(P <.05)。总分、疼痛严重程度、疼痛模式和诱发疼痛的因素与住院率相关(P <.05)。总分与伊兹比基量表和简明疼痛量表评分相关(P <.0001)。问卷在稳定期患者中的信度良好,组内相关系数为0.89。
COMPAT - SF问卷涵盖了CP疼痛最相关的方面,是一种可行、可靠且有效的疼痛评估工具,推荐在未来试验中使用。