Test–retest and interobserver reliability of quantitative sensory testing according to the protocol of the German Research Network on Neuropathic Pain (DFNS): A multi-centre study

Abstract

Quantitative sensory testing (QST) is an instrument to assess positive and negative sensory signs, helping to identify mechanisms underlying pathologic pain conditions. In this study, we evaluated the test-retest reliability (TR-R) and the interobserver reliability (IO-R) of QST in patients with sensory disturbances of different etiologies. In 4 centres, 60 patients (37 male and 23 female, 56.4±1.9years) with lesions or diseases of the somatosensory system were included. QST comprised 13 parameters including detection and pain thresholds for thermal and mechanical stimuli. QST was performed in the clinically most affected test area and a less or unaffected control area in a morning and an afternoon session on 2 consecutive days by examiner pairs (4 QSTs/patient). For both, TR-R and IO-R, there were high correlations (r=0.80-0.93) at the affected test area, except for wind-up ratio (TR-R: r=0.67; IO-R: r=0.56) and paradoxical heat sensations (TR-R: r=0.35; IO-R: r=0.44). Mean IO-R (r=0.83, 31% unexplained variance) was slightly lower than TR-R (r=0.86, 26% unexplained variance, P<.05); the difference in variance amounted to 5%. There were no differences between study centres. In a subgroup with an unaffected control area (n=43), reliabilities were significantly better in the test area (TR-R: r=0.86; IO-R: r=0.83) than in the control area (TR-R: r=0.79; IO-R: r=0.71, each P<.01), suggesting that disease-related systematic variance enhances reliability of QST. We conclude that standardized QST performed by trained examiners is a valuable diagnostic instrument with good test-retest and interobserver reliability within 2days. With standardized training, observer bias is much lower than random variance. Quantitative sensory testing performed by trained examiners is a valuable diagnostic instrument with good interobserver and test-retest reliability for use in patients with sensory disturbances of different etiologies to help identify mechanisms of neuropathic and non-neuropathic pain.

Changes in Pain Sensitivity and Pain Modulation During Oral Opioid Treatment: The Impact of Negative Affect

“…First, with no control group, we cannot be certain that any changes we observe in QST responses are definitively opioid-related. Many QST studies have demonstrated the strong temporal stability of patients' responses on these measures [58], suggesting that the observed changes in the present study may well be due to medication effects, but we cannot rule out the possibility of other sensitization-or habituationproducing processes. Second, we do not have detailed data on medical comorbidities (e.g., fibromyalgia) that Table 3 Hierarchical linear regression predicting change in cold pain tolerance…”

Quantitative sensory testing somatosensory profiles in patients with cervical radiculopathy are distinct from those in patients with nonspecific neck–arm pain

“…This protocol comprises all of the somatosensory submodalities that are mediated by different primary afferents (C-, Aδ-, Aβ-) as outlined in the following sections. Good test/retest-and inter-observer-reliability of this protocol has been demonstrated for all sub-modalities except wind-up ratio and the number of paradoxical heat sensations [27]. QST measurements were taken from the maximal pain area nominated by the patients and their contralateral mirror side for the neck-arm pain patients and unilaterally from the maximal pain area on the most painful side for patients with FM (Fig.…”

Short-term effects of orthognathic surgery on somatosensory function and recovery pattern in the early postoperative period

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