Sensory bedside testing: a simple stratification approach for sensory phenotyping
File(s)
Author(s)
Type
Journal Article
Abstract
Introduction: Stratification of patients according to the individual sensory phenotype has been suggested a promising method to
identify responders for pain treatment. However, many state-of-the-art sensory testing procedures are expensive or time-consuming.
Objectives: Therefore, this study aimed to present a selection of easy-to-use bedside devices.
Methods: In total, 73 patients (39 m/34 f) and 20 controls (11 m/9 f) received a standardized laboratory quantitative sensory testing
(QST) and a bedside-QST. In addition, 50 patients were tested by a group of nonexperienced investigators to address the impact of
training. The sensitivity, specificity, and receiver-operating characteristics were analyzed for each bedside-QST parameter as
compared to laboratory QST. Furthermore, the patients’ individual sensory phenotype (ie, cluster) was determined using laboratory
QST, to select bedside-QST parameters most indicative for a correct cluster allocation.
Results: The bedside-QST parameters “loss of cold perception to 22˚C metal,” “hypersensitivity towards 45˚C metal,” “loss of tactile
perception to Q-tip and 0.7 mm CMS hair,” as well as “the allodynia sum score” indicated good sensitivity and specificity (ie, ≳70%).
Results of interrater variability indicated that training is necessary for individual parameters (ie, CMS 0.7). For the cluster assessment,
the respective bedside quantitative sensory testing (QST) parameter combination indicated the following agreements as compared
to laboratory QST stratification: excellent for “sensory loss” (area under the curve [AUC] 5 0.91), good for “thermal hyperalgesia”
(AUC 5 0.83), and fair for “mechanical hyperalgesia” (AUC 5 0.75).
Conclusion: This study presents a selection of bedside parameters to identify the individual sensory phenotype as cost and time
efficient as possible.
identify responders for pain treatment. However, many state-of-the-art sensory testing procedures are expensive or time-consuming.
Objectives: Therefore, this study aimed to present a selection of easy-to-use bedside devices.
Methods: In total, 73 patients (39 m/34 f) and 20 controls (11 m/9 f) received a standardized laboratory quantitative sensory testing
(QST) and a bedside-QST. In addition, 50 patients were tested by a group of nonexperienced investigators to address the impact of
training. The sensitivity, specificity, and receiver-operating characteristics were analyzed for each bedside-QST parameter as
compared to laboratory QST. Furthermore, the patients’ individual sensory phenotype (ie, cluster) was determined using laboratory
QST, to select bedside-QST parameters most indicative for a correct cluster allocation.
Results: The bedside-QST parameters “loss of cold perception to 22˚C metal,” “hypersensitivity towards 45˚C metal,” “loss of tactile
perception to Q-tip and 0.7 mm CMS hair,” as well as “the allodynia sum score” indicated good sensitivity and specificity (ie, ≳70%).
Results of interrater variability indicated that training is necessary for individual parameters (ie, CMS 0.7). For the cluster assessment,
the respective bedside quantitative sensory testing (QST) parameter combination indicated the following agreements as compared
to laboratory QST stratification: excellent for “sensory loss” (area under the curve [AUC] 5 0.91), good for “thermal hyperalgesia”
(AUC 5 0.83), and fair for “mechanical hyperalgesia” (AUC 5 0.75).
Conclusion: This study presents a selection of bedside parameters to identify the individual sensory phenotype as cost and time
efficient as possible.
Date Issued
2020-05-01
Date Acceptance
2020-03-27
Citation
PAIN Reports, 2020, 5 (3)
ISSN
2471-2531
Publisher
Lippincott, Williams & Wilkins
Journal / Book Title
PAIN Reports
Volume
5
Issue
3
Copyright Statement
Copyright © 2020 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf
of The International Association for the Study of Pain. This is an open-access article
distributed under the terms of the Creative Commons Attribution-Non CommercialNo Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and
share the work provided it is properly cited. The work cannot be changed in any way
or used commercially without permission from the journal.
of The International Association for the Study of Pain. This is an open-access article
distributed under the terms of the Creative Commons Attribution-Non CommercialNo Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and
share the work provided it is properly cited. The work cannot be changed in any way
or used commercially without permission from the journal.
Identifier
http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000693786400001&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
Subjects
Science & Technology
Life Sciences & Biomedicine
Neurosciences
Neurosciences & Neurology
Bedside sensory testing
Bedside-QST
Quantitative sensory testing
Sensory profiling
Stratified therapy
PERIPHERAL NEUROPATHIC PAIN
DOUBLE-BLIND
DIABETIC-NEUROPATHY
OXCARBAZEPINE
LIDOCAINE
PROTOCOL
DFNS
Publication Status
Published
Date Publish Online
2020-05-21