Clinical indicators to identify neuropathic pain in low back related leg pain: a modified Delphi study
Abstract Background Neuropathic pain (NP) is common in patients presenting with low back related leg pain. Accurate diagnosis of NP is fundamental to ensure appropriate intervention. In the absence of a clear gold standard, expert opinion provides a useful methodology to progress research and clinic...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2020-09-01
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| Series: | BMC Musculoskeletal Disorders |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12891-020-03600-y |
| _version_ | 1811294722666266624 |
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| author | Jai Mistry Deborah Falla Tim Noblet Nicola R. Heneghan Alison Rushton |
| author_facet | Jai Mistry Deborah Falla Tim Noblet Nicola R. Heneghan Alison Rushton |
| author_sort | Jai Mistry |
| collection | DOAJ |
| description | Abstract Background Neuropathic pain (NP) is common in patients presenting with low back related leg pain. Accurate diagnosis of NP is fundamental to ensure appropriate intervention. In the absence of a clear gold standard, expert opinion provides a useful methodology to progress research and clinical practice. The aim of this study was to achieve expert consensus on a list of clinical indicators to identify NP in low back related leg pain. Methods A modified Delphi method consisting of three rounds was designed in accordance with the Conducting and Reporting Delphi Studies recommendations. Recruitment involved contacting experts directly and through expressions of interest on social media. Experts were identified using pre-defined eligibility criteria. Priori consensus criteria were defined for each round through descriptive statistics. Following completion of round 3 a list of clinical indicators that achieved consensus were generated. Results Thirty-eight participants were recruited across 11 countries. Thirty-five participants completed round 1 (92.1%), 32 (84.2%) round 2 and 30 (78.9%) round 3. Round 1 identified consensus (Kendall’s W coefficient of concordance 0.456; p < 0.001) for 10 clinical indicators out of the original 14, and 9 additional indicators were added to round 2 following content analysis of qualitative data. Round 2 identified consensus (Kendall’s W coefficient of concordance 0.749; p < 0.001) for 10 clinical indicators out of 19, and 1 additional indicator was added to round 3. Round 3 identified consensus for 8 indicators (Kendall’s W coefficient of concordance 0.648; p < 0.001). Following completion of the third round, an expert derived consensus list of 8 items was generated. Two indicators; pain variously described a burning, electric shock like and/or shooting into leg and pain in association with other neurological symptoms (e.g. pins and needles, numbness, weakness), were found to have complete agreement amongst expert participants. Conclusions Good agreement was found for the consensus derived list of 8 clinical indicators to identify NP in low back related leg pain. This list of indicators provide some indication of the criteria upon which clinicians can identify a NP component to low back related leg pain; further research is needed for stronger recommendations to be made. |
| first_indexed | 2024-04-13T05:21:41Z |
| format | Article |
| id | doaj.art-086b877770f2488d85b1060388cb9043 |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-04-13T05:21:41Z |
| publishDate | 2020-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-086b877770f2488d85b1060388cb90432022-12-22T03:00:44ZengBMCBMC Musculoskeletal Disorders1471-24742020-09-0121111510.1186/s12891-020-03600-yClinical indicators to identify neuropathic pain in low back related leg pain: a modified Delphi studyJai Mistry0Deborah Falla1Tim Noblet2Nicola R. Heneghan3Alison Rushton4St Georges Hospital NHS Foundation TrustCentre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of BirminghamSt Georges Hospital NHS Foundation TrustCentre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of BirminghamCentre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of BirminghamAbstract Background Neuropathic pain (NP) is common in patients presenting with low back related leg pain. Accurate diagnosis of NP is fundamental to ensure appropriate intervention. In the absence of a clear gold standard, expert opinion provides a useful methodology to progress research and clinical practice. The aim of this study was to achieve expert consensus on a list of clinical indicators to identify NP in low back related leg pain. Methods A modified Delphi method consisting of three rounds was designed in accordance with the Conducting and Reporting Delphi Studies recommendations. Recruitment involved contacting experts directly and through expressions of interest on social media. Experts were identified using pre-defined eligibility criteria. Priori consensus criteria were defined for each round through descriptive statistics. Following completion of round 3 a list of clinical indicators that achieved consensus were generated. Results Thirty-eight participants were recruited across 11 countries. Thirty-five participants completed round 1 (92.1%), 32 (84.2%) round 2 and 30 (78.9%) round 3. Round 1 identified consensus (Kendall’s W coefficient of concordance 0.456; p < 0.001) for 10 clinical indicators out of the original 14, and 9 additional indicators were added to round 2 following content analysis of qualitative data. Round 2 identified consensus (Kendall’s W coefficient of concordance 0.749; p < 0.001) for 10 clinical indicators out of 19, and 1 additional indicator was added to round 3. Round 3 identified consensus for 8 indicators (Kendall’s W coefficient of concordance 0.648; p < 0.001). Following completion of the third round, an expert derived consensus list of 8 items was generated. Two indicators; pain variously described a burning, electric shock like and/or shooting into leg and pain in association with other neurological symptoms (e.g. pins and needles, numbness, weakness), were found to have complete agreement amongst expert participants. Conclusions Good agreement was found for the consensus derived list of 8 clinical indicators to identify NP in low back related leg pain. This list of indicators provide some indication of the criteria upon which clinicians can identify a NP component to low back related leg pain; further research is needed for stronger recommendations to be made.http://link.springer.com/article/10.1186/s12891-020-03600-yNeuropathic painLow back related leg painClinical indicatorsDelphi |
| spellingShingle | Jai Mistry Deborah Falla Tim Noblet Nicola R. Heneghan Alison Rushton Clinical indicators to identify neuropathic pain in low back related leg pain: a modified Delphi study BMC Musculoskeletal Disorders Neuropathic pain Low back related leg pain Clinical indicators Delphi |
| title | Clinical indicators to identify neuropathic pain in low back related leg pain: a modified Delphi study |
| title_full | Clinical indicators to identify neuropathic pain in low back related leg pain: a modified Delphi study |
| title_fullStr | Clinical indicators to identify neuropathic pain in low back related leg pain: a modified Delphi study |
| title_full_unstemmed | Clinical indicators to identify neuropathic pain in low back related leg pain: a modified Delphi study |
| title_short | Clinical indicators to identify neuropathic pain in low back related leg pain: a modified Delphi study |
| title_sort | clinical indicators to identify neuropathic pain in low back related leg pain a modified delphi study |
| topic | Neuropathic pain Low back related leg pain Clinical indicators Delphi |
| url | http://link.springer.com/article/10.1186/s12891-020-03600-y |
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