The sensitivity and specificity of using the McGill pain subscale for diagnosing neuropathic and non-neuropathic chronic pain in the total joint arthroplasty population.
Dragana Boljanovic-Susic, Christina Ziebart, Joy MacDermid and 3 others
PMID 37095584WHAT IT FOUND
The McGill Pain Questionnaire Neuropathic Subscale (NP-MPQ SF-2) showed good accuracy in identifying neuropathic pain in patients with chronic pain after joint replacement.
A score of 0.91 or higher was the optimal cutoff, with 89.5% sensitivity and 75.0% specificity.
Key findings
01The NP-MPQ (SF-2) subscale demonstrated good diagnostic accuracy with an Area Under the Curve (AUC) of 0.89 when compared to the S-LANSS reference standard.
02The optimal cut-off score for the NP-MPQ (SF-2) to identify neuropathic pain was 0.91 points, achieving 89.5% sensitivity and 75.0% specificity.
03Using the S-LANSS reference standard, 28% of participants were classified as having neuropathic pain, whereas the NP-MPQ (SF-2) classified 43%.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study used the S-LANSS, which is itself an imperfect screening tool, as the reference standard instead of a gold-standard clinical diagnosis. The sample size was small (n=67), which may affect the stability of the ROC analysis results. The response rate was 53%, and the participants were limited to those with chronic pain after surgery, so results may not generalize to all post-arthroplasty patients. Data were collected via mail-in survey without clinician examination, relying on self-reported accuracy. The study did not determine if neuropathic pain was present before surgery.
Declared interests
No specific conflicts of interest or funding sources were reported in the provided text.
The easy way to misread this
Do not assume the NP-MPQ SF-2 is a definitive diagnostic tool. It was compared against another screening questionnaire (S-LANSS), not a gold-standard clinical examination. The higher classification rate of neuropathic pain by NP-MPQ SF-2 (43%) compared to S-LANSS (28%) suggests potential overestimation or bias, and further validation against expert clinical diagnosis is needed.