PainDETECT: a suitable screening tool for neuropathic pain in patients with painful post-traumatic trigeminal nerve injuries?

Elias, Leigh Ann; Yılmaz, Zehra; Smith, Jared G.; Bouchiba, Mustapha; Valk, Ramon A van der; Page, Lisa; Barker, Sarah; Renton, Tara

doi:10.1016/j.ijom.2013.07.004

Cited by 24 publications

(26 citation statements)

References 24 publications

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“…Although there is a need for characterizing and quantifying NeP concurrently with its identification in patients with various NeP conditions, to our knowledge, no other NeP instrument has yet been specifically validated for distinguishing between levels of average pain severity. These results therefore complement and extend studies that have suggested that NeP-screening instruments may help distinguish among sensory symptom profiles and pain-severity levels 16,17,25–27…”

Section: Discussionsupporting

confidence: 84%

“…The initial painDETECT-validation study reported a significant association ( P <0.001) between pain severity (average over the past 4 weeks) and painDETECT scores,15 and other studies have confirmed that higher painDETECT scores were significantly associated with greater average pain severity over the previous 4 weeks ( P <0.05) 16,17. However, those studies evaluated the relationship within the framework of the painDETECT cutoff values for differentiating NeP from nociceptive pain.…”

Section: Discussionmentioning

confidence: 98%

“…Since pain severity is not only of immediate importance to patients but also increases the overall burden, characterizing pain-severity levels when identifying patients with NeP can help inform treatment decisions. Although an association between pain severity and painDETECT scores was suggested in several studies, including the original painDETECT-validation study,15–17 this relationship has not been psychometrically evaluated with the goal of differentiating NeP severity. Therefore, the purpose of this study was to determine whether painDETECT can differentiate among levels of average pain severity in patients with NeP.…”

Section: Introductionmentioning

confidence: 99%

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Measurement properties of painDETECT by average pain severity

Cappelleri¹,

Bienen

Koduru³

et al. 2014

CEOR

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BackgroundSince the burden of neuropathic pain (NeP) increases with pain severity, it is important to characterize and quantify pain severity when identifying NeP patients. This study evaluated whether painDETECT, a screening questionnaire to identify patients with NeP, can distinguish pain severity.Materials and methodsSubjects (n=614, 55.4% male, 71.8% white, mean age 55.5 years) with confirmed NeP were identified during office visits to US community-based physicians. The Brief Pain Inventory – Short Form stratified subjects by mild (score 0–3, n=110), moderate (score 4–6, n=297), and severe (score 7–10, n=207) average pain. Scores on the nine-item painDETECT (seven pain-symptom items, one pain-course item, one pain-irradiation item) range from −1 to 38 (worst NeP); the seven-item painDETECT scores (only pain symptoms) range from 0 to 35. The ability of painDETECT to discriminate average pain-severity levels, based on the average pain item from the Brief Pain Inventory – Short Form (0–10 scale), was evaluated using analysis of variance or covariance models to obtain unadjusted and adjusted (age, sex, race, ethnicity, time since NeP diagnosis, number of comorbidities) mean painDETECT scores. Cumulative distribution functions on painDETECT scores by average pain severity were compared (Kolmogorov–Smirnov test). Cronbach’s alpha assessed internal consistency reliability.ResultsUnadjusted mean scores were 15.2 for mild, 19.8 for moderate, and 24.0 for severe pain for the nine items, and 14.3, 18.6, and 22.7, respectively, for the seven items. Adjusted nine-item mean scores for mild, moderate, and severe pain were 17.3, 21.3, and 25.3, respectively; adjusted seven-item mean scores were 16.4, 20.1, and 24.0, respectively. All pair-wise comparisons of scores between pain-severity groups showed sizable and statistically significant differences (P<0.0001). Cumulative distribution functions showed distinct separation between severity (P<0.0001). Cronbach’s alphas were 0.76 and 0.80 for the nine- and seven-item scales, respectively.ConclusionThis study provides strong psychometric evidence on the validity and reliability of painDETECT for distinguishing average pain severity in patients with NeP.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

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Measurement properties of painDETECT by average pain severity

Cappelleri¹,

Bienen

Koduru³

et al. 2014

CEOR

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“…Previous psychological stressors in childhood and personality or anxiety disorders appear to reduce the capacity of the pain modulation system (Kehlet et al , ; Macrae, ; Schreiber et al , ). ▪Cognitive – fear of surgery and anxiety and fear of pain (Kehlet et al , ; Macrae, ; Schreiber et al , ). ▪Personality disorders (increased preoperative anxiety, introverted personality, catastrophising, poor coping skills, hypervigilance states; Kehlet et al , odi12540-bib-0014"/>; Macrae, ; Schreiber et al , ). ▪Psychological vulnerability – pain‐related fear (Kehlet et al , ; Schreiber et al , ). ▪Social support (Kehlet et al , ). ▪Solicitous responding – empathetic spouse encouraging negative behaviour and Munchausen (Schreiber et al , ). ▪Post‐traumatic stress disorder (PTSD) is reported in post‐traumatic neuropathy with pain in the trigeminal system (Elias et al , ) and is also reported with chronic pelvic pain syndromes, particularly if iatrogenic. Post‐traumatic stress disorder (PTSD) is a major anxiety disorder initiated by exposure to a traumatic event. ○Family history of anxiety and or depression, a personal or family history of depression is found in 66% of cases of fibromyalgia and it may decrease the patient's capacity to inhibit pain.…”

Section: Risk Factors For Developing Chronic Pain After Routine Surgimentioning

confidence: 99%

“…A recent review reported that the DN4 and the Neuropathic Pain Questionnaire were most suitable for clinical use (Mathieson et al, 2015). However, their sensitivity and specificity for chronic pain in the trigeminal system is poor (Elias et al, 2014).…”

Section: Risk Factors For Developing Chronic Pain After Routine Surgimentioning

confidence: 99%

Chronic orofacial pain

Renton

2016

Oral Diseases

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The issues specific to trigeminal pain include the complexity of the region, the problematic impact on daily function and significant psychological impact (J Dent, 43, 2015, 1203). By nature of the geography of the pain (affecting the face, eyes, scalp, nose, mouth), it may interfere with just about every social function we take for granted and enjoy (J Orofac Pain, 25, 2011, 333). The trigeminal nerve is the largest sensory nerve in the body, protecting the essential organs that underpin our very existence (brain, eyes, nose, mouth). It is no wonder that pain within the trigeminal system in the face is often overwhelming and inescapable for the affected individual.

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