A prospective, multisite, international validation of the Complex Regional Pain Syndrome Severity Score
Harden RN, Maihofner C, Abousaad E, Vatine JJ, Kirsling A, Perez RSGM, Kuroda M, Brunner F, Stanton-Hicks M, Marinus J, Van Hilten JJ, Mackey S, Birklein FI, Schlereth T, Mailis-Gagnon A, Graciosa J, Connoly SB, Dayanim D, Massey M, Frank H, Livshitz A, Bruehl S (2017)
Publication Type: Journal article
Publication year: 2017
Journal
Book Volume: 158
Pages Range: 1430-1436
Journal Issue: 8
DOI: 10.1097/j.pain.0000000000000927
Abstract
Clinical diagnosis of complex regional pain syndrome (CRPS) is a dichotomous (yes/no) categorization, a format necessary for clinical decision making. Such dichotomous diagnostic categories do not convey an individual's subtle gradations in the severity of the condition over time and have poor statistical power when used as an outcome measure in research. This prospective, international, multicenter study slightly modified and further evaluated the validity of the CRPS Severity Score (CSS), a continuous index of CRPS severity. Using a prospective design, medical evaluations were conducted in 156 patients with CRPS to compare changes over time in CSS scores between patients initiating a new treatment program and patients on stable treatment regimens. New vs stable categorizations were supported by greater changes in pain and function in the former. Results indicated that CSS values in the stable CRPS treatment group exhibited much less change over time relative to the new treatment group, with intraclass correlations nearly twice as large in the former. A calculated smallest real difference value revealed that a change in the CSS of ≥4.9 scale points would indicate real differences in CRPS symptomatology (with 95% confidence). Across groups, larger changes in CRPS features on the CSS over time were associated in the expected direction with greater changes in pain intensity, fatigue, social functioning, ability to engage in physical roles, and general well-being. The overall pattern of findings further supports the validity of the CSS as a measure of CRPS severity and suggests it may prove useful in clinical monitoring and outcomes research.
Additional Organisation(s)
Involved external institutions
Vanderbilt University
United States (USA) (US)
Tel Aviv University
Israel (IL)
Shirley Ryan AbilityLab
United States (USA) (US)
Cleveland Clinic
United States (USA) (US)
University of Toronto
Canada (CA)
Universitätsmedizin der Johannes Gutenberg-Universität Mainz
Germany (DE)
Stanford University
United States (USA) (US)
Leiden University
Netherlands (NL)
Universitätsklinik Balgrist
Switzerland (CH)
Free University Medical Center / VU Medisch Centrum
Netherlands (NL)
United States (USA) (US)
Tel Aviv University
Israel (IL)
Shirley Ryan AbilityLab
United States (USA) (US)
Cleveland Clinic
United States (USA) (US)
University of Toronto
Canada (CA)
Universitätsmedizin der Johannes Gutenberg-Universität Mainz
Germany (DE)
Stanford University
United States (USA) (US)
Leiden University
Netherlands (NL)
Universitätsklinik Balgrist
Switzerland (CH)
Free University Medical Center / VU Medisch Centrum
Netherlands (NL)
How to cite
APA:
Harden, R.N., Maihofner, C., Abousaad, E., Vatine, J.-J., Kirsling, A., Perez, R.S.G.M.,... Bruehl, S. (2017). A prospective, multisite, international validation of the Complex Regional Pain Syndrome Severity Score. Pain, 158(8), 1430-1436. https://dx.doi.org/10.1097/j.pain.0000000000000927
MLA:
Harden, R. Norman, et al. "A prospective, multisite, international validation of the Complex Regional Pain Syndrome Severity Score." Pain 158.8 (2017): 1430-1436.
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