Article

International validation study using self-administered surveys.
OBJECTIVES: To investigate the utility and reliability of the International
Spinal Cord Injury Pain (ISCIP) Classification as used by clinicians. METHODS:
Seventy-five clinical vignettes (case histories) were prepared by the members of
the ISCIP Classification group and assigned to a category by consensus. Vignettes
were incorporated into an Internet survey distributed to clinicians. Clinicians
were asked, for each vignette, to decide on the number of pain components present
and to classify each using the ISCIP Classification. RESULTS: The average
respondent had 86% of the questions on the number of pain components correct. The
overall correctness in determining whether pain was nociceptive was 79%, whereas
the correctness in determining whether pain was neuropathic was 77%. Correctness
in determining if pain was musculoskeletal was 84%, whereas for visceral pain,
neuropathic at-level spinal cord injury (SCI) and below-level SCI pain it was
85%, 57% and 73%, respectively. Using strict criteria, the overall correctness in
determining pain type was 68% (versus an expected 95%), but with maximally
relaxed criteria, it increased to 85%. CONCLUSIONS: The reliability of use of the
ISCIP Classification by clinicians (who received minimal training in its use)
using a clinical vignette approach is moderate.
Some subtypes of pain proved
challenging to classify. The ISCIP should be tested for reliability by applying
it to real persons with pain after SCI. Based on the results of this validation
process, the instructions accompanying the ISCIP Classification for classifying
subtypes of pain have been clarified.

Langue : ANGLAIS

Tiré à part : OUI