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神经病理性疼痛诊断与疗效评定中国量表的验证研究

Validation study of the Chinese scale for the diagnosis and efficacy assessment of neuropathic pain

摘要目的:验证神经病理性疼痛诊断与疗效评定中国量表。方法:本研究共入选神经病理性疼痛患者53例,伤害感受性疼痛患者52例。入选的患者自行或由研究人员辅助填写神经病理性疼痛诊断与疗效评定中国量表,由经培训的研究人员为患者解释量表中的问题。使用克隆巴赫信度(Cronbach's α)系数、Spearman-Brown折半信度系数,Guttman Split-Half系数评价量表的信度;使用接受者操作特性曲线(ROC)下面积、敏感度、特异度、最佳界值、cut-off点对量表诊断性评价;使用抽样适合性检验(KMO)和巴特利特(Bartlett)检验及因子分析进行效度验证。结果:入组105例患者,其中男39例,女66例。神经病理性疼痛诊断与疗效评定中国量表的信度较好(Cronbach's α系数为0.806、Spearman-Brown折半信度系数为0.703,Guttman Split-Half系数为0.703);神经病理性疼痛诊断与疗效评定效度好(KMO值为0.727,Bartlett球形检验的卡方值为746.684, P<0.001,因子分析符合预期);对于神经病理性疼痛有较高的诊断性价值(ROC曲线下面积为0.973,最佳界值为0.886,敏感度为0.925,特异度为0.962)。 结论:神经病理性疼痛诊断与疗效评定中国量表信度效度较好,对于神经病理性疼痛诊断学价值高;部分条目提取信息有效性欠佳,有待进一步研究验证。

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abstractsObjective:To validate the Chinese scale for the diagnosis and assessment of neuropathic pain in clinical practice.Methods:A total of 53 patients with neuropathic pain and 52 patients with nociceptive pain were enrolled in this study. Participants either self-administered or were assisted by researchers to complete the Corrected Neuropathic Pain Diagnosis and Efficacy Assessment Chinese Scale. The reliability of the scale was assessed using Cronbach's α coefficient, Spearman-Brown split-half reliability coefficient, and Guttman Split-Half coefficient. The diagnostic evaluation of the scale was conducted using the area under the receiver operating characteristic (ROC) curve, sensitivity, specificity, optimal cutoff value, and cut-off point. Validity of the scale was verified by Kaiser-Meyer-Olkin (KMO), Bartlett's tests and factor analysis.Results:The Neuropathic Pain Diagnosis and Efficacy Assessment Chinese Scale had a good reliability (Cronbach's α coefficient of 0.806, Spearman-Brown split-half reliability coefficient of 0.703, Guttman Split-Half coefficient of 0.703); and a good validity for the diagnosis and efficacy assessment (KMO value of 0.727, Bartlett's test of sphericity chi-square value of 746.684, P<0.001). The scale had a high diagnostic value for neuropathic pain (area under the ROC curve of 0.973, optimal cutoff value of 0.886, sensitivity of 0.925, specificity of 0.962). Conclusions:The Neuropathic Pain Diagnosis and Efficacy Assessment Chinese Scale has a good reliability and validity, and a high diagnostic value for neuropathic pain, though the validity of information extracted from some items is suboptimal and requires further research for validation.

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