PRELIMINARY REPORT OF RELIABILITY OF QUANTITATIVE SENSORY TESTING (QST) IN PATIENTS WITH PERSISTENT IDIOPATHIC DENTOALVEOLAR PAIN

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PRELIMINARY REPORT OF RELIABILITY OF QUANTITATIVE SENSORY TESTING (QST) IN PATIENTS WITH PERSISTENT IDIOPATHIC DENTOALVEOLAR PAIN

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Title PRELIMINARY REPORT OF RELIABILITY OF QUANTITATIVE SENSORY TESTING (QST) IN PATIENTS WITH PERSISTENT IDIOPATHIC DENTOALVEOLAR PAIN
Author(s) El-Masry Ivanovic, Susanne ; Faris, Hanan ; Baad-Hansen, Lene ; Svensson, Peter ; List, Thomas ; Drangsholt, Mark
Date 2010
English abstract
The German Network for Neuropathic Pain (DFNS) has recommended a protocol with 13 quantitative sensory testing (QST) measures for detection of somatosensory abnormalities. We have recently reported that the reliability of intraoral QST in healthy subjects is acceptable for most QST measures. This study investigated the inter- and intra-examiner reliability of 13 intraoral QST measures at the painful site and pain-free control site in patients with persistent idiopathic dentoalveolar pain. Methods: Seven female patients (61 ± 14 years) with atypical odontalgia (AO), a chronic continuous dentoalveolar pain (CCDAP) condition, have so far been included in this ongoing study. The average AO pain was 6.3 ± 2.4 assessed on a 0-10 numerical rating scale (NRS). Two trained, blinded examiners examined the patients using the DNFS QST protocol. Each patient was examined twice on the same day, once by each examiner (inter-examiner reliability). After 1-2 weeks, one examiner examined all patients again (intra-examiner reliability). The parameters tested were: thresholds for detection of cold (CDT) and warmth (WDT), pain on cold (CPT) and heat (HPT), thermal sensory limen (TSL) and paradoxical heat sensations during this procedure (PHS); thresholds for mechanical detection (MDT) and pain (MPT), vibration detection (VDT) and pressure pain (PPT); mechanical pain sensitivity (MPS), dynamic mechanical allodynia (DMA) and wind-up ratio (WUR) for pinprick pain were also recorded. All testing was made at the buccal gingiva adjacent to the painful tooth (P) and at a corresponding contralateral gingival site (CO). The skin of the right hand (thenar) was also tested. Intraclass correlation coefficient (ICC) for continuous variables and kappa value for categorical variables (PHS, DMA) were used to calculate correlations ICC <0.4 was considered poor; 0.4-0.59 fair; 0.6-0.75 good; and >0.75 excellent agreement, and for Kappa: ≤ 0.2 poor; 0.21-0.40 fair; 0.41-0.60 moderate; 0.61-0.80 good; and 0.81-1.00 excellent agreement. Results: On CO site, intra-examiner reliability was excellent for MPS, DMA and VDT; fair-good for CDT, TSL, MPT and WUR; poor for HPT, MDT and PPT. Inter-examiner reliability: excellent for DMA and VDT; fair-good for CDT, TSL, MPT and MPS; poor for WDT, CPT, HPT, MDT, WUR and PPT. On P site, intra-examiner reliability was excellent for MPS, VDT and PPT; fair-good for WDT, TSL, MDT and WUR; poor for CDT, CPT, HPT, DMA and MPT. Inter-examiner reliability: fair-good for CDT, CPT, MDT, MPT, MPS, VDT and PPT; poor for WDT, TSL, PHS, HPT, DMA and WUR. Conclusions: This initial assessment of the inter- and intra-examiner reliability of intraoral QST measures shows, that most are acceptable for assessment of somatosensory function in patients with persistent idiopathic dentoalveolar pain.
Publisher IASP (International Association for the Study of Pain and Omnipress)
Host/Issue Abstracts of the 13th World Congress of Pain
ISBN 978-0-931092-87-9
Pages Abstract number: PW 106
Language eng (iso)
Subject(s) Neuropathic pain
Orofacial pain
Atypical odontalgia
QST
Medicine
Research Subject Categories::ODONTOLOGY
Note 13th World Congress on Pain (IASP 2010), 29 Aug - 2 Sept, Montreal, Canada
Handle http://hdl.handle.net/2043/11330 (link to this page)
Link http://www.iasp-pain.org/AM/Template.cfm?Section=World_Congress_on_Pain&Template=/CM/HTMLDisplay.cfm&ContentID=9948 (external link to related web page)

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