Psychometric properties of patient-reported outcome measures in chronic pain conditions with central sensitization- a systematic review and meta-analysis.
Mst Farjana Akhter, Pavlos Bobos, Edith G Otalike, Nana A Tiwaa-Boateng, Andrew D Firth, Igor Karp, Joel J Gagnier
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Abstract
Purpose: 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.
Methods: 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.
Results: 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.
Conclusion: 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.
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