Ten Klooster Peter M, Simoes Jorge P, Vonkeman Harald E
Department of Psychology, Health and Technology, University of Twente, Enschede, The Netherlands.
Department of Rheumatology and Clinical Immunology, Medisch Spectrum Twente, Enschede, The Netherlands.
Rheumatol Adv Pract. 2024 Aug 26;8(3):rkae108. doi: 10.1093/rap/rkae108. eCollection 2024.
Central pain mechanisms may be prominent in a considerable subset of rheumatology patients with persistent pain. Several self-report instruments have been used in previous research to infer the presence and severity of central sensitization (CS) that stem from different definitions or approaches of CS. The current study aimed to evaluate and quantify the overlap of actual symptoms measured among self-report measures of CS in rheumatology.
We used Fried's (2017) comprehensive systematic approach to analyse the content of five commonly used or typical self-report measures (Generalized Pain Questionnaire, Pain Sensitivity Questionnaire, Central Sensitization Inventory, Central Aspects of Pain in the Knee scale and the painDETECT) used in rheumatology research and to visualize and quantify the overlap in symptoms measured.
The five instruments together measured 39 different symptoms, most of which could be grouped into nociplastic pain manifestations (7 symptoms), neuropathic pain qualities (5 symptoms), and psychosomatic symptoms and emotional distress (25 symptoms). Most symptoms (74.4%) were unique to a single instrument. Thermal allodynia was the most frequently measured symptom across the different instruments, assessed in four of the measures. Average content overlap was very low and ranged from no overlap at all to moderate overlap (Jaccard index = 0.43) between pairs of instruments.
There is high heterogeneity and limited overlap in the content of self-report measures used to infer central pain sensitization. This may lead to results that are specific to the particular instrument and may limit the generalizability and comparability of study findings in rheumatology research.
在相当一部分患有持续性疼痛的风湿病患者中，中枢性疼痛机制可能较为突出。先前的研究使用了几种自我报告工具来推断中枢敏化（CS）的存在和严重程度，这些工具源于对CS的不同定义或方法。本研究旨在评估和量化风湿病中CS自我报告测量方法所测量的实际症状的重叠情况。
我们采用弗里德（2017年）的综合系统方法，分析了风湿病研究中常用的或典型的五种自我报告测量方法（广义疼痛问卷、疼痛敏感性问卷、中枢敏化量表、膝关节疼痛的中枢方面量表和疼痛检测量表）的内容，并对所测量症状的重叠情况进行可视化和量化。
这五种工具共测量了39种不同症状，其中大多数可分为伤害性可塑性疼痛表现（7种症状）、神经性疼痛特征（5种症状）以及心身症状和情绪困扰（25种症状）。大多数症状（74.4%）是单一工具所特有的。不同工具中最常测量的症状是热痛觉过敏，有四种测量方法对其进行了评估。平均内容重叠度非常低，工具对之间的重叠度从完全无重叠到中度重叠（杰卡德指数=0.43）不等。
用于推断中枢性疼痛敏化的自我报告测量方法的内容存在高度异质性且重叠有限。这可能导致特定于特定工具的结果，并可能限制风湿病研究中研究结果的普遍性和可比性。
