Reliability of conditioned pain modulation: a systematic review.
Reliability of conditioned pain modulation: a systematic review.
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DOI：
10.1097/j.pain.0000000000000689
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发表时间：
2016-11
期刊：
影响因子：
7.4
通讯作者：
Rice ASC
中科院分区：
文献类型：
--
作者：
Kennedy DL;Kemp HI;Ridout D;Yarnitsky D;Rice ASC
补充数字内容在文本中可用。进行了系统的文献综述，以确定条件性疼痛调制（CPM）是否可靠。纵向，英语观察性研究的CPM测试范式在成年人的重复性。两名独立的评审员评估了6个领域的偏倚风险;研究参与;研究损耗;预后因素测量;结局测量;混杂和使用预后研究质量（QUIPS）关键评估工具进行分析。组内相关系数（ICC）小于0.4被认为是差; 0.4和0.59被认为是一般; 0.6和0.75被认为是好，大于0.75被认为是极好。10项研究被纳入最终审查。由于研究之间的差异，荟萃分析不适用。在8项研究中调查了CPM效果的会话间可靠性，3项研究报告为良好（ICC = 0.6-0.75），其中2项亚组报告为极好（ICC > 0.75）。偏倚风险评估表明，报告对样本人口统计学、招募策略和研究损耗的描述不全面。缺乏盲法、缺乏对混杂因素的控制以及统计分析缺乏标准化是常见的。条件性疼痛调制是一种可靠的测量方法;然而，可靠性程度在很大程度上取决于刺激参数和研究方法，这需要研究者考虑。CPM可靠性研究报告的改进可能有助于在实验和临床疼痛研究中验证CPM作为一个强大的预后因素。
Supplemental Digital Content is Available in the Text. 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 6 domains; study participation; study attrition; prognostic factor measurement; outcome measurement; confounding and analysis using the Quality in Prognosis Studies (QUIPS) critical assessment tool. 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. Ten studies were included in the final review. Meta-analysis was not appropriate because of differences between studies. The intersession reliability of the CPM effect was investigated in 8 studies and reported as good (ICC = 0.6-0.75) in 3 studies and excellent (ICC > 0.75) 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. Conditioned pain modulation is a reliable measure; however, the degree of reliability is heavily dependent on 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.