A 4, 2, AND 1 STEPPING ALGORITHM FOR QUICK AND ACCURATE ESTIMATION OF CUTANEOUS SENSATION THRESHOLD
A 4, 2, AND 1 STEPPING ALGORITHM FOR QUICK AND ACCURATE ESTIMATION OF CUTANEOUS SENSATION THRESHOLD
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DOI：
10.1212/wnl.43.8.1508
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发表时间：
1993-08-01
期刊：
影响因子：
9.9
通讯作者：
KARNES, JL
中科院分区：
文献类型：
--
作者：
DYCK, PJ;OBRIEN, PC;KARNES, JL
在定量感觉测试中，某些方法可能导致振动（VDT）、冷（CDT）或热（WDT）检测阈值的不正确估计。我们已经表明，在我们的计算机辅助感觉检查（CASE IV）系统中采用的特定强制选择测试算法，与其他神经功能障碍测试相比，提供了这些阈值的准确和可重复的估计。由于这种强制选择算法很耗时，并且困倦或无聊可能会使性能变差，因此我们探索了其他算法，这些算法可能提供与强制选择算法相似的阈值估计值，但更快。在25名健康受试者和25名神经病患者的试验中，部分基于计算机模拟的比较数据和患者决策的见解，使用零刺激的4、2和1步进算法提供了阈值的准确估计。平均而言，强制选择测试所需的时间为12.8 +/- 2.9分钟（平均值+/- SD）。对于4步、2步和1步测试，时间为2.7 +/- 2.5分钟--节省了大量时间。由于在4、2和1步进算法中采用了零刺激，因此可以监测虚假反应，如果它们以过高的速率发生，则可以重复测试。该算法似乎足够稳健，可推荐用于临床使用以及一些对照临床和流行病学试验。
In quantitative sensory testing, certain methods may lead to incorrect estimates of vibratory (VDT), cool (CDT), or warm (WDT) detection thresholds. We have shown that the specific forced-choice algorithm of testing employed in our Computer-Assisted Sensory Examination (CASE IV) system, when compared with other tests of nerve dysfunction, provides accurate and reproducible estimates of these thresholds. Because this forced-choice algorithm is time consuming and performance might be made worse by drowsiness or boredom, we explored other algorithms that might provide estimates of threshold similar to those obtained with the forced-choice algorithm, but more quickly. In a trial of 25 healthy subjects and 25 patients with neuropathy, the 4, 2, and 1 stepping algorithm with null stimuli, based in part on comparative data from computer simulation and insights from patient decision making, provides an accurate estimate of threshold. On average, the time needed for forced-choice testing was 12.8 +/- 2.9 minutes (mean +/- SD). For 4, 2, and 1 stepping testing, it was 2.7 +/- 2.5 minutes-a large saving of time. Since null stimuli were employed in the 4, 2, and 1 stepping algorithm, it was possible to monitor for spurious responses and repeat the test if they occurred at an excessive rate. The algorithm appears to be sufficiently robust to be recommended for clinical use and for some controlled clinical and epidemiologic trials.