Quantitative sensory testing - Report of the therapeutics and technology assessment subcommittee of the American Academy of Neurology
Quantitative sensory testing - Report of the therapeutics and technology assessment subcommittee of the American Academy of Neurology
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DOI：
10.1212/01.wnl.0000058546.16985.11
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发表时间：
2003-03-25
期刊：
影响因子：
9.9
通讯作者：
Weimer, LH
中科院分区：
文献类型：
--
作者：
Shy, ME;Frohman, EM;Weimer, LH
目的：本评估评估定量感官测试 (QST) 的临床实用性、有效性和安全性。方法：通过搜索 MEDLINE、当前内容及其个人文件，作者确定了 350 篇文章。选定的文章使用计算机操作的阈值系统、手动操作的阈值系统和电动阈值装置。作者评估了正常值的使用以及相同和不同系统之间的再现性程度。使用标准证据分类方案对文章进行评级。结果：由于系统之间的差异，一个系统的正常值不能转换到其他系统。结果的可重复性也是一个重要问题，但对于如何定义它尚未达成共识。作者发现没有足够有力的 I 类研究证明 QST 在评估任何特定疾病方面的有效性。许多 II 类和 III 类研究表明，QST 可能或可能有助于识别糖尿病神经病、小纤维神经病、尿毒症神经病和脱髓鞘性神经病患者的小纤维或大纤维感觉异常。结论：QST 是测量临床和研究感觉障碍的潜在有用工具。然而，QST 结果不应成为诊断病理的唯一标准。由于装病和其他非器质性因素会影响检测结果，因此 QST 目前无法用于解决法医学问题。需要精心设计的研究来比较不同的 QST 设备和方法，并且应包括仅通过 QST 检测到异常的患者。
Objective: This assessment evaluates the clinical utility, efficacy, and safety of quantitative sensory testing (QST). Methods: By searching MEDLINE, Current Contents, and their personal files, the authors identified 350 articles. Selected articles utilized computer operated threshold systems, manually operated threshold systems, and electrical, threshold devices. The authors evaluated the use of normal values and the degree of reproducibility between the same and different systems. Articles were rated using a standard classification of evidence scheme. Results: Because of differences between systems, normal values from one system cannot be transposed to others. Reproducibility of results was also an important concern, and there is no consensus on how it should be defined. The authors identified no adequately powered class I studies demonstrating the effectiveness of QST in evaluating any particular disorder. A number of class II and III studies demonstrated that QST is probably or possibly useful in identifying small or large fiber sensory abnormalities in patients with diabetic neuropathy, small fiber neuropathies, uremic neuropathies, and demyelinating neuropathy. Conclusions: QST is a potentially useful tool for measuring sensory impairment for clinical and research studies. However, QST results should not be the sole criteria used to diagnose pathology. Because malingering and other nonorganic factors can influence the test results, QST is not currently useful for the purpose of resolving medicolegal matters. Well-designed studies comparing different QST devices and methodologies are needed and should include patients with abnormalities detected solely by QST.