Retrospective Assessment of Endometriosis Pain Over the Life Course: A Reliability Study Within the ComPaRe-Endometriosis Cohort

IF 3.5 2区医学 Q1 ANESTHESIOLOGY

European Journal of Pain Pub Date : 2025-05-13 DOI:10.1002/ejp.70040

Solène Gouesbet, Sarah Lambert, Hélène Amazouz, Zélia Breton, Viet-Thi Tran, Stacey Missmer, Marina Kvaskoff

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引用次数: 0

Abstract

Background

Endometriosis may manifest through various pain symptoms, such as dysmenorrhea, dyspareunia, dyschezia, dysuria and abdominal pain. While retrospective evaluation of these pain symptoms is less expensive and time-consuming compared to a prospective evaluation, there is potential for recall bias, and the reliability of such data needs to be assessed. We aimed to evaluate the reliability of questions on past endometriosis-related pain.

Methods

We conducted a reliability study within ComPaRe-Endometriosis, an ongoing prospective e-cohort including patients with endometriosis. We assessed past endometriosis-related pain over a lifetime using the WERF-EPHect Patient Questionnaire—Standard (EPQ-S). Participants rated the worst intensity of dysmenorrhea, dyspareunia, dyschezia, dysuria and abdominal pain that they experienced at ≤ 15, 16–20, 21–30, 31–40 and > 40 years using a numeric-rating scale (NRS). We asked the same questions about 1 year later and measured the agreement between participant responses by calculating intraclass correlation coefficients (ICC) (continuous NRS level) and weighted kappa coefficients (κ_w) (pain intensity categories).

Results

A total of 1752 participants completed both surveys. The global reliability was close to the ‘good’ and ‘substantial’ thresholds for dysmenorrhea (ICC = 0.74; κ_w = 0.57) and dyspareunia (ICC = 0.72; κ_w = 0.57), ‘moderate’ and close to the ‘substantial’ threshold for dysuria (ICC = 0.68; κ_w = 0.59), and ‘moderate’ for dyschezia (ICC = 0.62; κ_w = 0.54) and abdominal pain (ICC = 0.58; κ_w = 0.49).

Conclusions

In this population, questions on worst pain intensity over the life course showed moderate-to-good reliability depending on the type of pain, with higher reliability when pain level was considered as a continuous variable.

Significance Statement

While prospective measures are the most robust approach in epidemiological research, longitudinal data with pain recorded since childhood or adolescence are scarce. This study shows that the worst level of pelvic and abdominal pain over the life course are reliably reported by endometriosis patients after a 1-year interval. These findings suggest that retrospective pain assessment may reliably be used to assess trajectories of pain over the life course in order to gain insights into the progression of pain-related conditions such as endometriosis.

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子宫内膜异位症患者生命过程中疼痛的回顾性评估：一项比较-子宫内膜异位症队列的可靠性研究

背景子宫内膜异位症可表现为各种疼痛症状，如痛经、性交困难、运动障碍、排尿困难和腹痛。虽然与前瞻性评估相比，对这些疼痛症状进行回顾性评估成本更低，耗时更短，但存在回忆偏倚的可能性，需要对这些数据的可靠性进行评估。我们的目的是评估过去子宫内膜异位症相关疼痛问题的可靠性。方法我们在ComPaRe-Endometriosis中进行了一项可靠性研究，这是一项正在进行的前瞻性e队列研究，包括子宫内膜异位症患者。我们使用WERF-EPHect患者问卷标准（EPQ-S）评估过去一生中子宫内膜异位症相关疼痛。参与者使用数字评定量表（NRS）对≤15岁、16-20岁、21-30岁、31-40岁和40岁时经历的痛经、性交困难、精神障碍、排尿困难和腹痛的最严重程度进行评分。我们在1年后询问了同样的问题，并通过计算类内相关系数（ICC）（连续NRS水平）和加权kappa系数（κw）（疼痛强度类别）来衡量参与者之间的反应一致性。结果共1752名参与者完成了两项调查。总体信度接近痛经的“良好”和“大量”阈值(ICC = 0.74；κw = 0.57)和性交困难(ICC = 0.72；κw = 0.57)，“中度”且接近“实质性”排尿困难阈值(ICC = 0.68；κw = 0.59)，精神障碍为“中度”(ICC = 0.62；κw = 0.54)和腹痛(ICC = 0.58；κw = 0.49)。在这个人群中，根据疼痛的类型，关于生命过程中最严重疼痛强度的问题显示出中等到良好的可靠性，当疼痛水平被认为是一个连续变量时，可靠性更高。虽然前瞻性措施是流行病学研究中最可靠的方法，但从童年或青春期开始记录疼痛的纵向数据很少。这项研究表明，子宫内膜异位症患者在生命周期中最严重的骨盆和腹部疼痛是在间隔1年后可靠报告的。这些发现表明，回顾性疼痛评估可以可靠地用于评估生命过程中的疼痛轨迹，以便深入了解疼痛相关疾病（如子宫内膜异位症）的进展。

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 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.