The measurement of "high-impact chronic pain": Limitations and alternative methods.

IF 3.5 2区 医学 Q1 ANESTHESIOLOGY
Daniel L Riddle, Levent Dumenci
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引用次数: 0

Abstract

Objective: Chronic pain is known to be an important construct in clinical practice and a particular form of chronic pain, high-impact chronic pain (HICP), has gained recent interest and attention by pain clinicians, epidemiologists, and clinical researchers. The purpose of our Topical Review is to describe the historical development of measures of HICP and to explore the psychometric properties of HICP as well as to present alternative measurement methods.

Methods: We identified strengths and weaknesses of the psychometric characteristics of HICP measures. Limitations of existing HICP measures were discussed and summarized and alternatives to current methods were proposed.

Results: HICP operational definitions show variability across studies. All definitions cannot be correct, but which ones are incorrect cannot be determined as there is no gold standard. Random measurement error and recall bias are among the other limitations of current HICP measures. Model-based definitions of HICP, the discrete (for epidemiologic applications) and continuous (for clinical applications) latent variable models are discussed as likely superior alternatives to current methods.

Conclusions: Limitations of existing HICP methods are discussed and alternative development approaches to HICP measures are presented. The use of either discrete or continuous latent variable models would improve upon the psychometric characteristics of current HICP evidence. Examples are used to illustrate the benefits of latent variable models over traditional observed variable conceptualizations as the measurement of HICP continues to develop.

Significance statement: This work takes the position that current methods of measuring high impact chronic pain (HICP) likely contain substantial error. We have endorsed an alternative approach for several psychometrically grounded reasons. We recommend that future work consider the discrete latent variable framework for dichotomous measures of HICP and the continuous latent variable framework for continuous measures of HICP. The paper provides illustrative examples of these methods for a different patient reported measure that is lacking a gold standard, much like HICP measures.

高强度慢性疼痛 "的测量:局限性和替代方法。
目的:众所周知,慢性疼痛是临床实践中的一个重要概念,而一种特殊形式的慢性疼痛--高影响慢性疼痛(HICP)--近来引起了疼痛临床医生、流行病学家和临床研究人员的兴趣和关注。我们的专题综述旨在描述 HICP 测量方法的历史发展,探讨 HICP 的心理测量特性,并介绍其他测量方法:方法:我们确定了衡量 HICP 的心理测量特性的优缺点。我们讨论并总结了现有 HICP 测量方法的局限性,并提出了当前方法的替代方法:不同研究对 HICP 的操作定义存在差异。不可能所有定义都是正确的,但由于没有黄金标准,因此无法确定哪些定义是不正确的。随机测量误差和回忆偏差是当前 HICP 测量方法的其他局限性。基于模型的 HICP 定义、离散(用于流行病学应用)和连续(用于临床应用)潜变量模型可能是目前方法的优越替代方法:结论:讨论了现有 HICP 方法的局限性,并提出了 HICP 测量的替代发展方法。使用离散或连续潜变量模型都将改善目前 HICP 证据的心理测量特性。举例说明了随着 HICP 测量方法的不断发展,潜变量模型比传统的观察变量概念更有优势:这项工作的立场是,目前测量高影响慢性疼痛(HICP)的方法可能包含大量误差。出于几个基于心理测量学的原因,我们赞同采用另一种方法。我们建议今后的工作考虑采用离散潜变量框架来测量二分法的高冲击慢性疼痛,以及采用连续潜变量框架来测量连续法的高冲击慢性疼痛。本文提供了这些方法的示例,用于一种不同的患者报告测量方法,该方法与 HICP 测量方法一样缺乏金标准。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
European Journal of Pain
European Journal of Pain 医学-临床神经学
CiteScore
7.50
自引率
5.60%
发文量
163
审稿时长
4-8 weeks
期刊介绍: European Journal of Pain (EJP) publishes clinical and basic science research papers relevant to all aspects of pain and its management, including specialties such as anaesthesia, dentistry, neurology and neurosurgery, orthopaedics, palliative care, pharmacology, physiology, psychiatry, psychology and rehabilitation; socio-economic aspects of pain are also covered. Regular sections in the journal are as follows: • Editorials and Commentaries • Position Papers and Guidelines • Reviews • Original Articles • Letters • Bookshelf The journal particularly welcomes clinical trials, which are published on an occasional basis. Research articles are published under the following subject headings: • Neurobiology • Neurology • Experimental Pharmacology • Clinical Pharmacology • Psychology • Behavioural Therapy • Epidemiology • Cancer Pain • Acute Pain • Clinical Trials.
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