School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada.
Physical Therapy and Surgery, Western University, London, Ontario, Canada.
Pain Med. 2023 Jun 1;24(6):602-609. doi: 10.1093/pm/pnac189.
To determine the extent of agreement between the original Central Sensitization Inventory (CSI) and the Rasch-calibrated version (RC-CSI) and to explore the association of both versions with psychophysical tests and their respective sensitivity and specificity.
Patients with knee osteoarthritis who were enrolled in a multicenter cohort study in Montreal, Canada, completed the original CSI, the RC-CSI, and psychophysical tests (i.e., pressure pain thresholds, temporal summation, conditioned pain modulation) according to standardized protocols. Bland-Altman analyses assessed the agreement between the original CSI and the RC-CSI; Spearman correlations and chi-squared analyses evaluated the association between the two CSI scores and the psychophysical tests. A CSI cut point of 40 and an RC-CSI cut point of 31.37 were used. Receiver operating characteristic curves and the resulting sensitivity and specificity with psychophysical tests were also analyzed.
Two hundred ninety-three participants were included (58.7% female, mean age of 63.6 years, and body mass index 31.9 kg/m2). The original CSI and RC-CSI mean difference, 3.3/8.2, t(292) = 8.84 (P < 0.001), was significantly different and indicated a small bias. Small but significant inverse correlations were found for the original CSI and RC-CSI scores with pressure pain thresholds at the forearm and patella, with variance explained ranging from 0.01 to 0.12. The largest area under the curve suggested cut points of 23 (CSI) and 25 (RC-CSI) with 80.9% sensitivity and 38.5% specificity.
Because of poor variance explained with psychophysical tests and high false positive rates, our results indicate that there is little clinical value of using either version of the CSI in people with knee osteoarthritis.
确定原始中央敏感化量表（CSI）与经 Rasch 校准的版本（RC-CSI）之间的一致性程度，并探讨这两个版本与心理物理测试的关联，以及各自的敏感性和特异性。
加拿大蒙特利尔多中心队列研究纳入了膝关节骨关节炎患者，他们根据标准化方案完成了原始 CSI、RC-CSI 和心理物理测试（即压力疼痛阈值、时间总和、条件性疼痛调制）。Bland-Altman 分析评估了原始 CSI 和 RC-CSI 之间的一致性；Spearman 相关分析和卡方分析评估了两个 CSI 评分与心理物理测试之间的关联。使用 CSI 切点 40 和 RC-CSI 切点 31.37。还分析了接收者操作特征曲线以及与心理物理测试相关的敏感性和特异性。
共纳入 293 名参与者（58.7%为女性，平均年龄 63.6 岁，体重指数为 31.9kg/m2）。原始 CSI 和 RC-CSI 的平均差异为 3.3/8.2，t（292）= 8.84（P < 0.001），差异显著且存在小的偏差。原始 CSI 和 RC-CSI 评分与前臂和髌骨处的压力疼痛阈值呈显著负相关，解释方差范围为 0.01 至 0.12。曲线下面积最大的建议切点为 23（CSI）和 25（RC-CSI），具有 80.9%的敏感性和 38.5%的特异性。
由于与心理物理测试的解释方差较小和假阳性率较高，我们的结果表明，在膝关节骨关节炎患者中使用 CSI 的任何版本都几乎没有临床价值。
