Cost-Saving Early Diagnosis of Functional Pain in Nonmalignant Pain: A Noninferiority Study of Diagnostic Accuracy.

Q2 Medicine
Pain Research and Treatment Pub Date : 2016-01-01 Epub Date: 2016-03-21 DOI:10.1155/2016/5964250
Rafael J A Cámara, Christian Merz, Barbara Wegmann, Stefanie Stauber, Roland von Känel, Niklaus Egloff
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引用次数: 7

Abstract

Objectives. We compared two index screening tests for early diagnosis of functional pain: pressure pain measurement by electronic diagnostic equipment, which is accurate but too specialized for primary health care, versus peg testing, which is cost-saving and more easily manageable but of unknown sensitivity and specificity. Early distinction of functional (altered pain perception; nervous sensitization) from neuropathic or nociceptive pain improves pain management. Methods. Clinicians blinded for the index screening tests assessed the reference standard of this noninferiority diagnostic accuracy study, namely, comprehensive medical history taking with all previous findings and treatment outcomes. All consenting patients referred to a university hospital for nonmalignant musculoskeletal pain participated. The main analysis compared the receiver operating characteristic (ROC) curves of both index screening tests. Results. The area under the ROC curve for peg testing was not inferior to that of electronic equipment: it was at least 95% as large for finger measures (two-sided p = 0.038) and at least equally as large for ear measures (two-sided p = 0.003). Conclusions. Routine diagnostic testing by peg, which is accessible for general practitioners, is at least as accurate as specialized equipment. This may shorten time-to-treatment in general practices, thereby improving the prognosis and quality of life.

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功能性疼痛在非恶性疼痛中的早期诊断:诊断准确性的非劣效性研究。
目标。我们比较了两种用于功能性疼痛早期诊断的指标筛选试验:通过电子诊断设备测量压痛,这是准确的,但对初级卫生保健来说过于专业化;与peg测试相比,peg测试更节省成本,更容易管理,但敏感性和特异性未知。早期区分功能性疼痛知觉改变;神经性或伤害性疼痛的神经致敏可改善疼痛管理。方法。盲法进行指标筛选试验的临床医生评估本非劣效性诊断准确性研究的参考标准,即综合病史,包括所有既往发现和治疗结果。所有因非恶性肌肉骨骼疼痛转介到大学医院的患者都参与了研究。主要分析比较两种指标筛选试验的受试者工作特征(ROC)曲线。结果。peg检测的ROC曲线下面积并不逊于电子设备:手指测量的面积至少为95%(双面p = 0.038),耳朵测量的面积至少为95%(双面p = 0.003)。结论。常规诊断测试的peg,这是可访问的全科医生,至少是一样准确的专业设备。这可能缩短一般治疗的时间,从而改善预后和生活质量。
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来源期刊
Pain Research and Treatment
Pain Research and Treatment Medicine-Anesthesiology and Pain Medicine
CiteScore
3.60
自引率
0.00%
发文量
0
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