Evans Valerie, Duarte Felipe Ck, Linde Lukas D, Kumbhare Dinesh
Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.
Institute of Biomaterials and Biomedical Engineering (IBBME), University of Toronto, Toronto, ON, Canada.
Br J Pain. 2021 Nov;15(4):441-449. doi: 10.1177/2049463720979340. Epub 2020 Dec 18.
In clinical practice, multiple questionnaires are often used as part of the diagnosis of chronic widespread pain. Body Surface Area (BSA), Visual Analogue Scale (VAS), Fibromyalgia Diagnostic Criteria (FDC) and Central Sensitization Inventory (CSI) have all been used as screening tools to assess pain status in individuals with widespread pain. However, substantial overlap can be observed among these commonly employed questionnaires. This study aimed to quantitatively determine the most independent and dependent clinical characteristics obtained through these questionnaires and to examine potential redundancies.
Seventy-nine participants with widespread pain, 61 females and 18 males, from a chronic pain outpatient clinic were recruited. The FDC, BSA, VAS and the CSI were measured for all participants. A principal component analysis (PCA) using a varimax rotation was used to determine which clinical measures represented separate constructs of widespread pain. This was followed by a regression analysis to assess redundancy between the constructs and related pain characteristics.
The identified three-component PCA solution was characterized by (1) the FDC and CSI score, (2) the VAS score and (3) the BSA score. This indicates that the BSA and the VAS scores capture independent patient information. From the regression analysis, the FDC and CSI scores shared approximately 80% of the variance, indicative of substantial overlap between scores.
Our findings demonstrated that BSA and VAS scores were independent clinical measures of widespread chronic pain, while the FDC and CSI scores were not independent, were highly correlated and provided redundant information. Clinicians should continue using both the BSA and VAS; however, either only FDC or CSI will be beneficial during clinical assessment of widespread chronic pain.
在临床实践中，多种问卷常被用作慢性广泛性疼痛诊断的一部分。体表面积（BSA）、视觉模拟评分法（VAS）、纤维肌痛诊断标准（FDC）和中枢敏化量表（CSI）均已被用作筛查工具，以评估广泛性疼痛个体的疼痛状况。然而，在这些常用问卷之间可观察到大量重叠。本研究旨在定量确定通过这些问卷获得的最独立和相关的临床特征，并检查潜在的冗余情况。
招募了来自慢性疼痛门诊的79名广泛性疼痛患者，其中61名女性，18名男性。对所有参与者测量FDC、BSA、VAS和CSI。使用方差最大化旋转的主成分分析（PCA）来确定哪些临床测量代表广泛性疼痛的不同结构。随后进行回归分析，以评估这些结构与相关疼痛特征之间的冗余情况。
确定的三成分PCA解决方案的特征为：（1）FDC和CSI评分，（2）VAS评分，（3）BSA评分。这表明BSA和VAS评分捕获了独立的患者信息。从回归分析来看，FDC和CSI评分共享约80%的方差，表明评分之间存在大量重叠。
我们的研究结果表明，BSA和VAS评分是广泛性慢性疼痛的独立临床测量指标，而FDC和CSI评分不独立，高度相关且提供冗余信息。临床医生应继续使用BSA和VAS；然而，在广泛性慢性疼痛的临床评估中，仅使用FDC或CSI其中之一将是有益的。
