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Reliability of Conditioned Pain Modulation: a Systematic Review

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Title: Reliability of Conditioned Pain Modulation: a Systematic Review
Authors: Kennedy, DL
Kemp, HI
Ridout, D
Yarnitsky, D
Rice, AS
Item Type: Journal Article
Abstract: A systematic literature review was undertaken to determine if conditioned pain modulation (CPM) is reliable. Longitudinal, English language observational studies of the repeatability of a CPM test paradigm in adult humans were included. Two independent reviewers assessed the risk of bias in six domains; study participation; study attrition; prognostic factor measurement; outcome measurement; confounding and analysis using the Quality in Prognosis Studies (QUIPS) critical assessment tool [17]. Intraclass correlation coefficients (ICCs) less than 0.4 were considered to be poor; 0.4 and 0.59 to be fair; 0.6 and 0.75 good and greater than 0.75 excellent [37]. Ten studies were included in the final review. Meta-analysis was not appropriate due to differences between studies. The intersession reliability of the CPM effect was investigated in 8 studies and reported as good (ICC = 0.6-.75) in 3 studies and excellent (ICC > .75) in subgroups in 2 of those 3. The assessment of risk of bias demonstrated that reporting is not comprehensive for the description of sample demographics, recruitment strategy and study attrition. The absence of blinding, a lack of control for confounding factors and lack of standardisation in statistical analysis are common. CPM is a reliable measure, however the degree of reliability is heavily dependent upon stimulation parameters and study methodology and this warrants consideration for investigators. The validation of CPM as a robust prognostic factor in experimental and clinical pain studies may be facilitated by improvements in the reporting of CPM reliability studies.
Issue Date: 22-Aug-2016
Date of Acceptance: 9-Jun-2016
URI: http://hdl.handle.net/10044/1/42078
DOI: http://dx.doi.org/10.1097/j.pain.0000000000000689
ISSN: 1872-6623
Publisher: Wolters Kluwer
Start Page: 2410
End Page: 2419
Journal / Book Title: Pain
Volume: 157
Issue: 11
Copyright Statement: © 2016 Wolters Kluwer Health, Inc. All rights reserved. This is the accepted version of an article published in final form at http://dx.doi.org/10.1097/j.pain.0000000000000689.
Sponsor/Funder: Health Education England (HEE)
Funder's Grant Number: CDRF-2013-04-009
Keywords: Anesthesiology
11 Medical And Health Sciences
17 Psychology And Cognitive Sciences
Publication Status: Published
Appears in Collections:Department of Surgery and Cancer