Neuropathic pain after surgery - A clinical validation study and assessment of accuracy measures of the 5-item NeuPPS scale.

IF 1.5 Q4 CLINICAL NEUROLOGY
Scandinavian Journal of Pain Pub Date : 2024-03-07 eCollection Date: 2024-01-01 DOI:10.1515/sjpain-2023-0072
Kenneth Geving Andersen, Karl Bang Christensen, Henrik Kehlet, Mathias Kvist Mejdahl
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引用次数: 0

Abstract

Objective: The aim of this study was to validate the Neuropathic Pain for Post-Surgical Patients (NeuPPS) scale against clinically verified neuropathic pain (NP) by quantitative sensory testing (QST) as well as evaluation of other psychometric properties. The NeuPPS is a validated 5-item scale designed to evaluate NP in surgical populations.

Methods: Data from 537 women aged >18 years scheduled for primary breast cancer surgery enrolled in a previous study for assessing risk factors for persistent pain after breast cancer treatment were used. Exclusion criteria were any other breast surgery or relevant comorbidity. A total of 448 eligible questionnaires were available at 6 months and 455 at 12 months. At 12 months, 290 patients completed a clinical examination and QST. NeuPPS and PainDETECT were analyzed against patients with and without clinically verified NP. NP was assessed using a standardized QST protocol including a clinical assessment. Furthermore, the NeuPPS and PainDETECT scores were psychometrically tested with an item response theory method, the Rasch analysis, to assess construct validity. Primary outcomes were the diagnostic accuracy measures for the NeuPPS, and secondary measures were psychometric analyses of the NeuPPS after 6 and 12 months. PainDETECT was also compared to clinically verified NP as well as NeuPPS comparing the stability of the estimates.

Results: Comparing the NeuPPS scores with verified NP using a receiver operating characteristic curve, the NeuPPS had an area under the curve of 0.80. Using a cutoff of 1, the NeuPPS had a sensitivity of 88% and a specificity of 59%, and using a cutoff of 3, the values were 35 and 96%, respectively. Analysis of the PainDETECT indicated that the used cutoffs may be inappropriate in a surgical population.

Conclusion: The present study supports the validity of the NeuPPS as a screening tool for NP in a surgical population.

手术后的神经性疼痛--一项临床验证研究以及对 5 项 NeuPPS 量表准确性的评估。
研究目的本研究旨在通过定量感觉测试(QST)验证手术后患者神经病理性疼痛(NeuPPS)量表与临床验证的神经病理性疼痛(NP)是否一致,并评估其他心理测量学特性。NeuPPS 是一个经过验证的 5 项量表,旨在评估手术人群中的 NP:研究使用了 537 名年龄大于 18 岁、计划接受原发性乳腺癌手术的女性的数据,这些女性曾参加过一项评估乳腺癌治疗后持续疼痛风险因素的研究。排除标准为任何其他乳腺手术或相关合并症。共有 448 份符合条件的调查问卷在 6 个月时有效,455 份在 12 个月时有效。在 12 个月时,290 名患者完成了临床检查和 QST。对患有和未患有经临床证实的 NP 的患者进行了 NeuPPS 和 PainDETECT 分析。NP 采用标准化 QST 方案进行评估,包括临床评估。此外,NeuPPS 和 PainDETECT 分数还通过项目反应理论方法(Rasch 分析法)进行了心理测试,以评估其构造效度。主要结果是NeuPPS的诊断准确性测量,次要结果是6个月和12个月后NeuPPS的心理测量分析。此外,还将 PainDETECT 与临床验证的 NP 和 NeuPPS 进行了比较,以比较估计值的稳定性:结果:使用接收器操作特征曲线将 NeuPPS 评分与验证的 NP 进行比较,NeuPPS 的曲线下面积为 0.80。以 1 为分界点,NeuPPS 的灵敏度为 88%,特异度为 59%;以 3 为分界点,灵敏度和特异度分别为 35% 和 96%。对 PainDETECT 的分析表明,在手术人群中使用的临界值可能并不合适:本研究支持 NeuPPS 作为外科人群 NP 筛查工具的有效性。
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来源期刊
Scandinavian Journal of Pain
Scandinavian Journal of Pain CLINICAL NEUROLOGY-
CiteScore
3.30
自引率
6.20%
发文量
73
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