A QST-based Pain Phenotype in Adults With Sickle Cell Disease: Sensitivity and Specificity of Quality Descriptors
A QST-based Pain Phenotype in Adults With Sickle Cell Disease: Sensitivity and Specificity of Quality Descriptors
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DOI：
10.1111/papr.12841
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发表时间：
2019-10-18
期刊：
影响因子：
2.6
通讯作者：
Wilkie, Diana J.
中科院分区：
文献类型：
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作者：
Dyal, Brenda W.;Ezenwa, Miriam O.;Wilkie, Diana J.
背景：我们试图改进一种筛选方法，用于区分患有镰状细胞病（SCD）的非裔美国成年人中的致敏或正常感觉疼痛表型。目的建立基于感觉疼痛质量描述符的评分系统，评价其对感觉过敏或感觉正常的SCD患者进行分类的性能，并与利兹神经病症状和体征自评量表（S-LANSS）和神经病疼痛症状量表（NPSI）评分进行比较。方法参与者完成PAINReportIt，定量感觉测试（QST），S-LANSS和NPSI。使用传统二元逻辑回归和最小绝对收缩和选择算子（lasso）回归获得2组权重，得到2个评分：PR-逻辑（通过传统二元逻辑回归系数加权的PAINReportIt评分）和PR-Lasso（通过lasso回归系数加权的PAINReportIt评分）。评价了拟定评分和现有评分的性能。结果Lasso回归得到一个简约模型，其中非零权重分配给2个神经病理描述符，寒冷和蔓延。PR-Lasso评分与S-LANSS（r = 0.22，P < 0.01）、NPSI（r = 0.22，P < 0.01）、PR-Logistic（r = 0.35，P < 0.01）评分呈正相关。NPSI和PR-Lasso在不同水平的所需特异性下表现相似，并且在各个特异性点上表现优于S-LANSS和PR-Logistic。结论PR-Lasso提供了一种鉴别SCD疼痛表型的方法。
Background We sought to refine a screening measure for discriminating a sensitized or normal sensation pain phenotype among African American adults with sickle cell disease (SCD). Objective To develop scoring schemes based on sensory pain quality descriptors; evaluate their performance on classifying patients with SCD who had sensitization or normal sensation, and compare with scores on the Self-report Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) and the Neuropathic Pain Symptom Inventory (NPSI). Methods Participants completed PAINReportIt, quantitative sensory testing (QST), S-LANSS, and NPSI. Conventional binary logistic regression and least absolute shrinkage and selection operator (lasso) regression were used to obtain 2 sets of weights resulting in 2 scores: the PR-Logistic (PAINReportIt score weighted by conventional binary logistic regression coefficients) and PR-Lasso (PAINReportIt score weighted by lasso regression coefficients). Performance of the proposed scores and the existing scores were evaluated. Results Lasso regression resulted in a parsimonious model with non-zero weights assigned to 2 neuropathic descriptors, cold and spreading. We found positive correlations between the PR-Lasso and other scores: S-LANSS (r = 0.22, P < 0.01), NPSI (r = 0.22, P < 0.01), and PR-Logistic (r = 0.35, P < 0.01). The NPSI and PR-Lasso performed similarly at different levels of required specificity and outperformed the S-LANSS and PR-Logistic at the various specificity points. Conclusion The PR-Lasso offers a way to discriminate a SCD pain phenotype.