Sachau Juliane, Appel Christina, Reimer Maren, Sendel Manon, Vollert Jan, Hüllemann Philipp, Baron Ralf
Division of Neurological Pain Research and Therapy, Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany.
Pain Research, MSk Lab, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, United Kingdom.
Pain Rep. 2023 Jan 13;8(1):e1049. doi: 10.1097/PR9.0000000000001049. eCollection 2023 Jan.
The sensory phenotype is believed to provide information about the underlying pathophysiological mechanisms and to be used in the diagnosis and treatment of chronic neuropathic pain. However, the use of standardized quantitative sensory testing (QST) protocols is limited due to high expenditures of time and costs. Thus, a simple bedside-QST battery was recently developed showing good agreement when compared with laboratory QST. The aim of this study was to preliminary validate this bedside-QST protocol.
Patients experiencing chronic pain with neuropathic features (n = 60) attended 3 visits. During the first visit, laboratory QST and bedside-QST were performed by the same trained investigator. Three hours and 3 weeks later, bedside-QST was repeated. Patients completed questionnaires regarding their pain (intensity, quality), depression/anxiety, and quality of life. Test-retest reliability and convergent/divergent validity were investigated.
Most of the bedside-QST parameters, including also those recommended in our first study as being indicative for sensory phenotypes, revealed a moderate to excellent test-retest reliability. Overall, results for short-term reliability and interval-scaled parameters were slightly better. Most of the bedside-QST parameters did not correlate with the depression and anxiety score, suggesting a good divergent validity.
Bedside-QST has good criterion and divergent validity as well as reliability. This battery consists of 5 low-cost devices that can be quickly and easily used to characterize the sensory phenotype of patients with neuropathic pain. A combination of bedside-QST parameters can be used to investigate patients' subgroups with specific pathophysiological mechanisms and to identify treatment responders.
感觉表型被认为能够提供有关潜在病理生理机制的信息，并用于慢性神经性疼痛的诊断和治疗。然而，由于时间和成本支出高昂，标准化定量感觉测试（QST）方案的应用受到限制。因此，最近开发了一种简单的床边QST组合，与实验室QST相比显示出良好的一致性。本研究的目的是对该床边QST方案进行初步验证。
患有神经性疼痛特征的慢性疼痛患者（n = 60）参加了3次就诊。在第一次就诊期间，由同一位经过培训的研究人员进行实验室QST和床边QST。3小时和3周后，重复进行床边QST。患者完成了关于其疼痛（强度、性质）、抑郁/焦虑和生活质量的问卷调查。研究了重测信度以及收敛/发散效度。
大多数床边QST参数，包括我们第一项研究中推荐的那些指示感觉表型的参数，都显示出中度至极好的重测信度。总体而言，短期信度和区间标度参数的结果略好。大多数床边QST参数与抑郁和焦虑评分无关，表明具有良好的发散效度。
床边QST具有良好的标准效度、发散效度和信度。该组合由5种低成本设备组成，可快速简便地用于表征神经性疼痛患者的感觉表型。床边QST参数的组合可用于研究具有特定病理生理机制的患者亚组，并识别治疗反应者。
