Akhter Mst Farjana, Bobos Pavlos, Otalike Edith G, Tiwaa-Boateng Nana A, Firth Andrew D, Karp Igor, Gagnier Joel J
Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada.
School of Physical Therapy, Western Health Science, Western University, London, ON, Canada.
J Patient Rep Outcomes. 2025 Jul 11;9(1):87. doi: 10.1186/s41687-025-00919-9.
To identify available patient-reported outcome measures (PROMs) used to evaluate central sensitization (CS) manifestations in chronic pain conditions and evaluate the quality of psychometric properties of those instruments.
A comprehensive search across multiple electronic databases was conducted for relevant studies following the specification of eligibility criteria and development of key search terms. After screening and full-text review, the methodological quality of studies and psychometric properties of PROMs were assessed and summarized using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist and scoring manual. The results were statistically pooled in a meta-analysis, specifically test-retest reliability, based on data availability and consistency of findings across studies.
A total of fifty-eight studies evaluating eight instruments in adult patients with chronic pain were included. The methodological quality of the included studies was varied. Most identified PROMs have limited evidence regarding their measurement properties. The Central Sensitization Inventory (CSI) received the highest overall ratings for most measurement properties among all the instruments, followed by Pain Sensitivity Questionnaire (PSQ) and Fibromyalgia Survey Questionnaire (FSQ). Based on pooled data from available studies, the test-retest reliability of the CSI was found to be excellent, with an intra-class correlation coefficient (ICC) of 0.93 (95% CI: 0.91-0.95) for overall chronic pain, 0.90 (95% CI: 0.87-0.93) for chronic musculoskeletal pain and 0.93 (95% CI: 0.88-0.99) for chronic neck pain. PSQ also demonstrated excellent test-retest reliability, showing an ICC of 0.86 (95% CI: 0.72-0.99) for chronic pain.
Although not all properties have been studied, the CSI, which received the highest overall ratings, could serve as a reliable PROM assessing CS in chronic pain. More studies should be performed to comprehensively evaluate all measurement properties of all included instruments.
确定用于评估慢性疼痛状况下中枢敏化（CS）表现的患者报告结局测量指标（PROMs），并评估这些工具的心理测量特性质量。
在明确纳入标准并制定关键检索词后，对多个电子数据库进行全面检索以查找相关研究。经过筛选和全文审查，使用基于共识的健康测量工具选择标准（COSMIN）清单和评分手册对研究的方法学质量和PROMs的心理测量特性进行评估和总结。根据数据可用性和各研究结果的一致性，将结果进行统计合并，进行荟萃分析，特别是重测信度分析。
共纳入58项评估成年慢性疼痛患者中8种工具的研究。纳入研究的方法学质量各不相同。大多数已确定的PROMs在测量特性方面的证据有限。在所有工具中，中枢敏化量表（CSI）在大多数测量特性方面获得的总体评分最高，其次是疼痛敏感性问卷（PSQ）和纤维肌痛调查问卷（FSQ）。根据现有研究的汇总数据，发现CSI的重测信度极佳，总体慢性疼痛的组内相关系数（ICC）为0.93（95%CI：0.91 - 0.95），慢性肌肉骨骼疼痛为0.90（95%CI：0.87 - 0.93），慢性颈部疼痛为0.93（95%CI：0.88 - 0.99）。PSQ也显示出极佳的重测信度，慢性疼痛的ICC为0.86（95%CI：0.72 - 0.99）。
尽管并非所有特性都已得到研究，但总体评分最高的CSI可作为评估慢性疼痛中CS的可靠PROM。应开展更多研究以全面评估所有纳入工具的所有测量特性。
