BackgroundThe current standard to evaluate the presence of somatosensory dysfunctions is quantitative sensory testing, but its clinical utility remains limited. Low‐cost and time‐efficient clinical sensory testing (CST) batteries have thus been developed. Recent studies show moderate to substantial reliability in populations with neuropathic pain. This study evaluates the inter‐ and intra‐tester reliability of people with spine‐related leg and arm pain, representing mixed pain mechanisms.MethodsFifty‐three patients with spine‐related leg (n = 41) and arm pain (n = 12) attended three CST sessions. The CST battery consisted of eleven tests, determining loss and gain of sensory nerve function. CST was performed by the same investigator twice and by an additional investigator to determine inter‐ and intra‐tester reliability. Fleiss' (inter‐tester) and Cohen's (intra‐tester) kappa were calculated for dichotomized and intraclass correlation coefficients (ICC) for continuous outcomes.ResultsFleiss' kappa varied among modalities from fair to substantial (κ = 0.23–0.66). Cold, warm, and vibration detection thresholds and cold and pressure pain thresholds reached kappa >0.4 (moderate to substantial reliability). Cohen's kappa ranged from moderate to substantial (κ = 0.45–0.66). The reliability of the windup ratio was poor (ICC <0.18).ConclusionCST modalities with moderate to substantial inter‐tester reliability could be of benefit as a screening tool. The moderate to substantial intra‐tester reliability for all sensory modalities (except windup ratio) supports their potential use in clinical practice and research to monitor somatosensory changes over time in patients with spine‐related limb pain of mixed pain mechanisms.SignificanceWe already know that most modalities of clinical sensory test (CST) batteries achieve moderate to substantial inter‐ and intra‐tester reliability in populations with neuropathic pain.This study evaluates the reliability of a CST battery in populations with mixed pain mechanisms. We found inter‐tester reliability varied from poor to substantial for sensory modalities, questioning the value of some CST modalities. The CST battery showed moderate to substantial intra‐tester reliability, suggesting its usefulness to monitor sensory changes over time in this cohort.

中文翻译：

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临床感觉测试电池组在脊柱相关腿部和手臂疼痛患者中的可靠性

背景目前评估体感功能障碍存在的标准是定量感觉测试，但其临床实用性仍然有限。因此开发了低成本且省时的临床感官测试（CST）电池。最近的研究表明，在患有神经性疼痛的人群中具有中等至显着的可靠性。本研究评估了脊柱相关腿部和手臂疼痛患者的测试者间和测试者内可靠性，代表了混合疼痛机制。 方法 53 名患有脊柱相关腿部疼痛的患者（n= 41) 和手臂疼痛 (n= 12) 参加了三届 CST 会议。 CST 电池由十一项测试组成，确定感觉神经功能的丧失和增强。 CST 由同一位研究者进行两次，并由另一位研究者进行，以确定测试者之间和测试者内部的可靠性。 Fleiss'（测试者间）和 Cohen's（测试者内）kappa 是针对连续结果的二分相关系数和组内相关系数 (ICC) 进行计算。结果 Fleiss' kappa 在不同模式之间变化，从一般到实质性 (κ = 0.23–0.66)。冷痛、热痛和振动检测阈值以及冷痛和压痛阈值达到 kappa >0.4（中等至较高可靠性）。 Cohen 的 kappa 范围从中度到显着 (κ = 0.45–0.66)。饱和比的可靠性很差（ICC <0.18）。结论具有中等至显着的测试者间可靠性的 CST 模式可能作为筛选工具是有益的。所有感觉模式（饱和比除外）的中等到显着的测试者内部可靠性支持它们在临床实践和研究中的潜在用途，以监测混合疼痛机制的脊柱相关肢体疼痛患者随时间的体感变化。意义我们已经知道，大多数临床感觉测试 (CST) 电池组的模式在患有神经性疼痛的人群中实现了中等至显着的测试者间和内部可靠性。本研究评估了 CST 电池组在具有混合疼痛机制的人群中的可靠性。我们发现感官模式的测试者间可靠性从差到高不等，质疑某些 CST 模式的价值。 CST 电池显示出中等至显着的测试者内部可靠性，表明其可用于监测该群体随时间的感觉变化。