Application and accuracy of the EAPC/IASP diagnostic algorithm for neuropathic cancer pain and quantitative sensory testing profile in patients with pain due to cancer
Abstract. Introduction:. Better diagnosis and treatment of neuropathic cancer pain (NcP) remains an unmet clinical need. The EAPC/IASP algorithm was specifically designed for NcP diagnosis; yet, to date, there is no information on its application and accuracy. Objectives:. Our aim was to determine t...
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2024-04-01
|
| Series: | PAIN Reports |
| Online Access: | http://journals.lww.com/painrpts/fulltext/10.1097/PR9.0000000000001140 |
| _version_ | 1797292762388758528 |
|---|---|
| author | Morena Shkodra Matthew Mulvey Marie Fallon Cinzia Brunelli Ernesto Zecca Paola Bracchi Mariangela Caputo Giacomo Massa Silvia Lo Dico Roman Rolke Stein Kaasa Augusto Caraceni |
| author_facet | Morena Shkodra Matthew Mulvey Marie Fallon Cinzia Brunelli Ernesto Zecca Paola Bracchi Mariangela Caputo Giacomo Massa Silvia Lo Dico Roman Rolke Stein Kaasa Augusto Caraceni |
| author_sort | Morena Shkodra |
| collection | DOAJ |
| description | Abstract. Introduction:. Better diagnosis and treatment of neuropathic cancer pain (NcP) remains an unmet clinical need. The EAPC/IASP algorithm was specifically designed for NcP diagnosis; yet, to date, there is no information on its application and accuracy.
Objectives:. Our aim was to determine the accuracy of the EAPC/IASP algorithm compared with the Neuropathic Special Interest Group grading system (gold standard) and to describe patients' sensory profile with quantitative sensory testing (QST).
Methods:. This is a cross-sectional observational study conducted in a palliative care and pain outpatient clinic. Patients with cancer pain intensity ≥3 (numerical rating scale 0–10) were eligible. The palliative care physician applied the EAPC/IASP algorithm as a grading system to diagnose probable or definite NcP, and an independent investigator applied the gold standard and performed the QST. Sensitivity and specificity of the EAPC/IASP algorithm were measured in comparison with the gold standard results. Kruskal–Wallis and unequal variance independent-samples t tests were used to compare the QST parameters in patients with and without NcP.
Results:. Ninety-eight patients were enrolled from August 2020 to March 2023. Sensitivity and specificity for the EAPC/IASP algorithm were 85% (95% CI 70.2–94.3) and 98.3% (95% CI 90.8–100), respectively. Patients with NcP in contrast to patients without NcP showed cold hypoesthesia (P = 0.0032), warm hypoesthesia (P = 0.0018), pressure hyperalgesia (P = 0.02), and the presence of allodynia (P = 0.0001).
Conclusion:. The results indicate a good performance of the EAPC/IASP algorithm in diagnosing NcP and the QST discriminated well between patients with and without NcP. |
| first_indexed | 2024-03-07T20:01:14Z |
| format | Article |
| id | doaj.art-7f6fd7bd20fa4efe86dfc466e7095d8d |
| institution | Directory Open Access Journal |
| issn | 2471-2531 |
| language | English |
| last_indexed | 2024-03-07T20:01:14Z |
| publishDate | 2024-04-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | PAIN Reports |
| spelling | doaj.art-7f6fd7bd20fa4efe86dfc466e7095d8d2024-02-28T06:49:26ZengWolters KluwerPAIN Reports2471-25312024-04-0192e114010.1097/PR9.0000000000001140PR90000000000001140Application and accuracy of the EAPC/IASP diagnostic algorithm for neuropathic cancer pain and quantitative sensory testing profile in patients with pain due to cancerMorena Shkodra0Matthew Mulvey1Marie Fallon2Cinzia Brunelli3Ernesto Zecca4Paola Bracchi5Mariangela Caputo6Giacomo Massa7Silvia Lo Dico8Roman Rolke9Stein Kaasa10Augusto Caraceni11a Palliative Care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italyc Leeds Institute of Health Sciences, University of Leeds, Leeds, United Kingdomd Department of Palliative Medicine, University of Edinburgh, Edinburgh, United Kingdoma Palliative Care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italya Palliative Care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italya Palliative Care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italya Palliative Care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italya Palliative Care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italya Palliative Care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italye Department of Palliative Medicine, Medical Faculty RWTH Aachen University, Aachen, Germanyb Institute of Clinical Medicine, University of Oslo, Oslo, Norwaya Palliative Care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, ItalyAbstract. Introduction:. Better diagnosis and treatment of neuropathic cancer pain (NcP) remains an unmet clinical need. The EAPC/IASP algorithm was specifically designed for NcP diagnosis; yet, to date, there is no information on its application and accuracy. Objectives:. Our aim was to determine the accuracy of the EAPC/IASP algorithm compared with the Neuropathic Special Interest Group grading system (gold standard) and to describe patients' sensory profile with quantitative sensory testing (QST). Methods:. This is a cross-sectional observational study conducted in a palliative care and pain outpatient clinic. Patients with cancer pain intensity ≥3 (numerical rating scale 0–10) were eligible. The palliative care physician applied the EAPC/IASP algorithm as a grading system to diagnose probable or definite NcP, and an independent investigator applied the gold standard and performed the QST. Sensitivity and specificity of the EAPC/IASP algorithm were measured in comparison with the gold standard results. Kruskal–Wallis and unequal variance independent-samples t tests were used to compare the QST parameters in patients with and without NcP. Results:. Ninety-eight patients were enrolled from August 2020 to March 2023. Sensitivity and specificity for the EAPC/IASP algorithm were 85% (95% CI 70.2–94.3) and 98.3% (95% CI 90.8–100), respectively. Patients with NcP in contrast to patients without NcP showed cold hypoesthesia (P = 0.0032), warm hypoesthesia (P = 0.0018), pressure hyperalgesia (P = 0.02), and the presence of allodynia (P = 0.0001). Conclusion:. The results indicate a good performance of the EAPC/IASP algorithm in diagnosing NcP and the QST discriminated well between patients with and without NcP.http://journals.lww.com/painrpts/fulltext/10.1097/PR9.0000000000001140 |
| spellingShingle | Morena Shkodra Matthew Mulvey Marie Fallon Cinzia Brunelli Ernesto Zecca Paola Bracchi Mariangela Caputo Giacomo Massa Silvia Lo Dico Roman Rolke Stein Kaasa Augusto Caraceni Application and accuracy of the EAPC/IASP diagnostic algorithm for neuropathic cancer pain and quantitative sensory testing profile in patients with pain due to cancer PAIN Reports |
| title | Application and accuracy of the EAPC/IASP diagnostic algorithm for neuropathic cancer pain and quantitative sensory testing profile in patients with pain due to cancer |
| title_full | Application and accuracy of the EAPC/IASP diagnostic algorithm for neuropathic cancer pain and quantitative sensory testing profile in patients with pain due to cancer |
| title_fullStr | Application and accuracy of the EAPC/IASP diagnostic algorithm for neuropathic cancer pain and quantitative sensory testing profile in patients with pain due to cancer |
| title_full_unstemmed | Application and accuracy of the EAPC/IASP diagnostic algorithm for neuropathic cancer pain and quantitative sensory testing profile in patients with pain due to cancer |
| title_short | Application and accuracy of the EAPC/IASP diagnostic algorithm for neuropathic cancer pain and quantitative sensory testing profile in patients with pain due to cancer |
| title_sort | application and accuracy of the eapc iasp diagnostic algorithm for neuropathic cancer pain and quantitative sensory testing profile in patients with pain due to cancer |
| url | http://journals.lww.com/painrpts/fulltext/10.1097/PR9.0000000000001140 |
| work_keys_str_mv | AT morenashkodra applicationandaccuracyoftheeapciaspdiagnosticalgorithmforneuropathiccancerpainandquantitativesensorytestingprofileinpatientswithpainduetocancer AT matthewmulvey applicationandaccuracyoftheeapciaspdiagnosticalgorithmforneuropathiccancerpainandquantitativesensorytestingprofileinpatientswithpainduetocancer AT mariefallon applicationandaccuracyoftheeapciaspdiagnosticalgorithmforneuropathiccancerpainandquantitativesensorytestingprofileinpatientswithpainduetocancer AT cinziabrunelli applicationandaccuracyoftheeapciaspdiagnosticalgorithmforneuropathiccancerpainandquantitativesensorytestingprofileinpatientswithpainduetocancer AT ernestozecca applicationandaccuracyoftheeapciaspdiagnosticalgorithmforneuropathiccancerpainandquantitativesensorytestingprofileinpatientswithpainduetocancer AT paolabracchi applicationandaccuracyoftheeapciaspdiagnosticalgorithmforneuropathiccancerpainandquantitativesensorytestingprofileinpatientswithpainduetocancer AT mariangelacaputo applicationandaccuracyoftheeapciaspdiagnosticalgorithmforneuropathiccancerpainandquantitativesensorytestingprofileinpatientswithpainduetocancer AT giacomomassa applicationandaccuracyoftheeapciaspdiagnosticalgorithmforneuropathiccancerpainandquantitativesensorytestingprofileinpatientswithpainduetocancer AT silvialodico applicationandaccuracyoftheeapciaspdiagnosticalgorithmforneuropathiccancerpainandquantitativesensorytestingprofileinpatientswithpainduetocancer AT romanrolke applicationandaccuracyoftheeapciaspdiagnosticalgorithmforneuropathiccancerpainandquantitativesensorytestingprofileinpatientswithpainduetocancer AT steinkaasa applicationandaccuracyoftheeapciaspdiagnosticalgorithmforneuropathiccancerpainandquantitativesensorytestingprofileinpatientswithpainduetocancer AT augustocaraceni applicationandaccuracyoftheeapciaspdiagnosticalgorithmforneuropathiccancerpainandquantitativesensorytestingprofileinpatientswithpainduetocancer |