Background: Recently symptoms-based screening questionnaires have gained attention for screening for a neuropathic pain component (NePC) in various chronic pain conditions. The present study assessed the usefulness of four commonly used NePC screening questionnaires including the Self-completed douleur neuropathique 4 (S-DN4), the ID Pain, the painDETECT questionnaire (PDQ), and the Self-completed Leeds Assessment of neuropathic Symptoms and Signs (S-LANSS) questionnaire in patients with chronic low back pain (CLBP) to assess the presence of NePC. Methods: This is a single-center cross-sectional study where patients with CLBP, with or without leg pain, were included. Participants were initially screened for NePC presence by a physician according to the regular practice, and later assessed using screening questionnaires. The diagnostic accuracy of these questionnaires was compared assuming the physician-made diagnosis as the gold standard. Results: A total of 215 patients with CLBP of which 164 (76.3%, 95% CI, 70.2-81.5) had a NePC were included. S-DN4, ID Pain, and PDQ have an area under the curve (AUC) > 0.8 indicating excellent discrimination. However, S-LANSS has an AUC of 0.69 (0.62-0.75), indicating low discrimination. S-DN4 has a significantly higher AUC as compared to ID Pain (d(AUC) = 0.063, P < 0.01) and S-LANSS (d(AUC) = 0.197, P < 0.01). But the AUC of S-DN4 does not significantly differ from that of PDQ (d(AUC) = 0.013, P = 0.62). Conclusions: S-DN4, ID Pain, and PDQ, but not S-LANSS, have good discriminant validity to screen for NePCs in patients with CLBP. Despite using all the tests, 20-30% of patients with an NePC were missed. Thus, these questionnaires can only be used as an initial clue in screening for NePCs, but do not replace clinical judgment.
Nabila, Rouahi;Zineb, OuazzaniTouhami;Hasna, Ahyayauch;Nisrin, El Mlili;A, Filali-Maltouf;Zakaria, Belkhadir
Asian Pacific Journal of Cancer Prevention
/
v.17
no.8
/
pp.3997-4001
/
2016
Background: Cancer is a worldwide health problem and pain is among the most common and unpleasant effects affecting well-being of cancer patients. Accurate description of pain can help physicians to improve its management. Many English tools have been developed to assess pain. Onkly a limited number of these are applied in Arab countries. Our aim was to assess the quality, the nature and the severity of pain using the short McGill Pain Questionnaire (SF-MPQ) on cancer patients in the National Institute of Oncology (NIO) in Rabat, Morocco. Materials and Methods: The tool used is the SF-MPQ inspired from the Arabic version of the MPQ. The subjects were cancer patients (N=182) attending the NIO, from 24th October 2015 to 8th January 2016, aging ${\geq}18$ years old, experiencing pain and coming to have or to update their pain medication. Results: The rate of participation was 96.3%. Eight patients had difficulties to express their pain using descriptors, but could use the Visual Analogue Scale (VAS) and the body diagram. The most frequent sensory descriptors were 'Throbbing', 'Shooting', 'Hot-Burning'. The most used affective descriptor was 'Tiring-Exhausting'. The mean VAS was 6.6 (2.4). The mean score of all items was 11.9 (7.8). The patients were suffering from severe pain. The internal consistency of the form was s acceptable. Conclusions: The findings indicate that most of the patients attending the pain center of the NIO could use the descriptors of the SF-MPQ to describe their pain. They indicate the usefulness of the SF-MPQ to assess the nature and the severity of pain in cancer patients. This tool should be tested in other Moroccan and Arabic contexts associated with other tools in clinical trials.
Kim, Tae Hee;Hong, Seung Wan;Woo, Nam Sik;Kim, Hae Kyoung;Kim, Jae Hun
The Korean Journal of Pain
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v.30
no.2
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pp.104-115
/
2017
Background: C-arm fluoroscopy equipment is important for interventional pain management and can cause radiation injury to physicians and patients. We compared radiation safety education and efforts to reduce the radiation exposure of pain specialists. Methods: A survey of 49 pain specialists was conducted anonymously in 2016. The questionnaire had 16 questions. That questionnaire was about radiation safety knowledge and efforts to reduce exposure. We investigated the correlation between radiation safety education and efforts of radiation protection. We compared the results from 2016 and a published survey from 2011. Results: According to the 2016 survey, all respondents used C-arm fluoroscopy in pain interventions. Nineteen respondents (39%) had received radiation safety education. Physicians had insufficient knowledge about radiation safety. When the radiation safety education group and the non-education group are compared, there was no significant difference in efforts to reduce radiation exposure and radiation safety knowledge. When the 2011 and 2016 surveys were compared, the use of low dose mode (P = 0.000) and pulsed mode had increased significantly (P = 0.001). The number checking for damage to radiation protective garments (P = 0.000) and use of the dosimeter had also increased significantly (P = 0.009). But there was no significant difference in other efforts to reduce radiation exposure. Conclusions: Pain physicians seem to lack knowledge of radiation safety and the number of physicians receiving radiation safety education is low. According to this study, education does not lead to practice. Therefore, pain physicians should receive regular radiation safety education and the education should be mandatory.
Background: Cancer-induced bone pain (CIBP) is considered to have both nociceptive and neuropathic components. However, the prevalence, risk factors, and impact of the neuropathic components are yet poorly understood. Methods: We estimate the prevalence of neuropathic pain (NP) features in patients with CIBP at a tertiary care pain clinic setting using the Douleur Neuropathique 4 questionnaire and evaluate their associated factors and their impact after 4 weeks of treatment using the Brief Pain Inventory questionnaire and the Edmonton Symptom Assessment System. Results: A total of 133 patients were recruited. The estimated prevalence of NP was 30.8% (95% confidence interval: 23.6%-39.1%). Initially, the patients with NP had significantly higher average pain scores (6.00 vs. 5.05, P = 0.006), higher total interference scores (5.84 vs. 4.89, P = 0.033), and symptom distress scores (35.88 vs. 26.52, P = 0.002). After 4 weeks of treatment, patients in both groups reported significantly decreased pain intensity and improved quality of life. However, the patients with NP still reported significantly higher average pain (4.61 vs. 3.58, P = 0.048), trending toward higher total interference scores (3.52 vs. 2.99, P = 0.426), and symptom distress scores (23.30 vs. 20.77, P = 0.524). From multivariate analysis, the independent risk factors for NP were younger age, pain in the extremities, and higher average pain scores. Conclusions: NP are common in patients with CIBP. These conditions negatively affect pain intensity and the patient's quality of life before and after treatment.
Aithala, Janardhana P.;Kumar, Suraj;Aithal, Shodhan;Kotian, Shashidhar M.
Asian Spine Journal
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v.12
no.6
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pp.1106-1116
/
2018
Study Design: Prospective observational study. Purpose: To evaluate the disability domains relevant to Indian patients with low backache and propose a modified disability questionnaire for such patients. Overview of Literature: The Oswestry Disability Index (ODI) is a self-reported measurement tool that measures both pain and functional status and is used for evaluating disability caused by lower backache. Although ODI remains a good tool for disability assessment, from the Indian perspective questions related to weight lifting and sexual activity of ODI are questioned in some of the earlier studies. Activities of daily living in Indian patients vary substantially from those in other populations and include activities like bending forwards, sitting in floor and squatting which are not represented in the ODI. Methods: In this prospective observational study, a seven-step approach was used for the development of a questionnaire. Thirty patients were interviewed to identify the most challenging issue they faced while performing their daily activities (by free listing) and understand how important the questionnaire items were in terms of the standard ODI. Thus, a comprehensive disability questionnaire comprising 14 questions was developed and administered to 88 patients. Both qualitative (interviews) and quantitative methods (to establish the validity, reliability, and correlation with the Visual Analog Scale [VAS] and Rolland Morris disability questionnaire) were used to identify the 10 questions that best addressed the disability domains relevant to Indian patients. Results: According to free listing, four new questions pertaining to bending forward, sitting on the floor, walking on uneven surfaces, and work-related disabilities were included. In the second phase, wherein the questionnaire with 14 items was used, 56.8% patients did not answer the questions related to sexual activity, whereas 23.8% did not answer those related to walking on uneven surfaces. The modified questionnaire demonstrated good internal consistency (Cronbach's alpha=0.892) and correlation with the Rolland Morris questionnaire (Cronbach's alpha=0.850, p>0.05), as well as with the VAS score for disability (Cronbach's alpha=0.712, p>0.05) and pain (Cronbach's alpha=0.625, p>0.05). Conclusions: A modified disability questionnaire that was designed by adding two questions related to bending forward and work status and removing questions related to sexual activity and weight lifting or traveling (depending on the occupation) can help evaluate disability caused by back pain in Indian population.
Objectives : The purpose of this study is to find out the effects of muscle energy techniques on nuchal pain caused by traffic accidents. Methods : The 20 patients were divided into 2 groups: group A was treated except muscle energy techniques and group B was treated with muscle energy techniques. Both groups were treated with acupunture treatment, physical theraphy and herbal medication. Patients were evaluated by McGill Pain Questionnaire-Short Form(SF-MPQ), Pain Disability Index(PDI) and Neck Disability Index(NDI) in traffic accident patients. Results : 1. Both Group were significantly decreased in sensory of SF-MPQ, VAS, PDI and NDI after 7 days of treatment. 2. Group B compared with the Group A was significantly decresed in VAS, PDI after 7 days of treatment. Conclusions : We found out that muscle energy techniques is considered to be effective and useful on nuchal pain caused by traffic accidents.
The aim of the present study was to compare measurement precisions of the Oswestry Back Pain Disability Questionnaire (ODQ) and a computer adaptive testing (CAT) method. The ODQ has been regarded as one of the most reliable condition-specific measure for back pain for decades. Cross-sectional study was carried out with two independent convenient samples from two out-patient rehabilitation clinics for back pain ($n_1=42$) and non-back pain group ($n_2=42$). Participants were asked to fill out the ODQ and CAT of International Classification of Functioning, Disability and Health-Activity Measure (ICF-AM). A series of Rasch analyses were performed to calculate person ability measures. The CAT measures had greater relative precision in discriminating the groups than did the ODQ measure in comparisons of the relative precision. The CAT measure appears to be more effective than did the ODQ measure in terms of measurement precision. By administering test items calibrated in a way, CAT measures using item response theory may promise a means with measurement precision as well as efficiency.
Kim, Sun-Kyung;Kang, Su-Jin;Hong, Ka-Kyung;Choi, Chang-Min
The Journal of Korean Obstetrics and Gynecology
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v.32
no.2
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pp.138-147
/
2019
Objectives: This study was to report clinical effect and safety of Traditional Korean Medical Treatment including Hwangryunhaedok-tang Pharmacopuncture for pregnant woman with low back pain with sciatica. Methods: The patient who suffered from sudden low back pain with sciatica was treated with Hwangryunhaedok-tang Pharmacopuncture, acupuncture, moxibustion, herbal medication and cupping therapy during admission. Visual Analog Score (VAS), Oswestry Disability Index (ODI), McGill pain questionnaire-short form (SF-MPQ) were checked to measure the outcome. Results: After treatment, Visual Analog Score (VAS), Oswestry disability index (ODI), McGill pain questionnaire-short form (SF-MPQ) were considerably improved in this case. Conclusions: The results indicate that Traditional Korean Medical Treatment including Hwangryunhaedok-tang Pharmacopuncture is the effective therapy for low back pain with sciatica during pregnancy.
Objective: This study aimed to investigate the potential benefits of microcurrent stimulation as a non-invasive therapeutic approach for managing pain and improving the quality of life in women suffering from primary dysmenorrhea. Design: A case study. Methods: This study was conducted, involving a cohort of 6 women diagnosed with primary dysmenorrhea, aged between 20 to 30 years. Participants were received microcurrent stimulation using low-intensity microcurrents for 30 minutes every day for 4 weeks. The intensity of microcurrent stimulation was 25 μA and the frequency was 8 Hz. The intervention was administered between the menstruations, with pain intensity and quality of life being assessed at baseline, and then at the end of menstrual cycle. Pain intensity was evaluated using a visual analog scale (VAS) and menstrual symptom questionnaire (MSQ), while the quality of life was assessed through the stress response inventory (SRI), state trait anxiety inventory (STAI), center for epidemiologic studies depression (CES-D), and menstrual distress questionnaire (MEDI-Q). Results: After the intervention, participants demonstrated a statistically significant reduction in pain intensity, as evidenced by improved VAS scores (p<0.05). However, the changes in MSQ scores did not reach statistical significance. Regarding quality of life measures, no statistically significant differences were found in the SRI, STAI, CES-D, and MEDI-Q scores after the intervention (p>0.05). Conclusions: This study suggest that microcurrent stimulation holds promise as a potential treatment option for alleviating pain associated with primary dysmenorrhea.
Objectives : The purpose of this thesis is to help the preparation of oriental medicine clinical guidelines for drawing up the standards of oriental medicine demonstration and diagnosis classification about the neck pain. Methods : Statistical analysis about Gyeonghangtong(頸項痛), Nakchim(落枕), Sagyeong(斜頸), Hanggang (項强) classified experts' opinions about neck pain patients by Delphi method is conducted by using oriental medicine diagnosis questionnaire. The result was classified by using linear discriminant analysis (LDA), diagonal linear discriminant analysis (DLDA), diagonal quadratic discriminant analysis (DQDA), K-nearest neighbor classification (KNN), classification and regression trees (CART), support vector machines (SVM). Results : The results are summarized as follows. 1. The result analyzed by using LDA has a hit rate of 84.47% in comparison with the original diagnosis. 2. High hit rate was shown when the test for three categories such as Gyeonghangtong and Hanggang category, Sagyeong caterogy and Nakchim caterogy was conducted. 3. The result analyzed by using DLDA has a hit rate of 58.25% in comparison with the original diagnosis. The result analyzed by using DQDA has a accuracy of 57.28% in comparison with the original diagnosis. 4. The result analyzed by using KNN has a hit rate of 69.90% in comparison with the original diagnosis. 5. The result analyzed by using CART has a hit rate of 69.60% in comparison with the original diagnosis. There was a hit rate of 70.87% When the test of selected 8 significant questions based on analysis of variance was performed. 6. The result analyzed by using SVM has a hit rate of 80.58% in comparison with the original diagnosis. Conclusions : Statistical analysis using oriental medicine diagnosis questionnaire on neck pain generally turned out to have a significant result.
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