Smith, BH, Torrance, N, Ferguson, JA et al. (3 more authors) (2012) Towards a definition of refractory neuropathic pain for epidemiological research. An international Delphi survey of experts. BMC Neurology, 12 (29). ARTN 29. ISSN 1471-2377
Abstract
Background: Best current estimates of neuropathic pain (NeuP) prevalence come from studies using various screening detecting pain with probable neuropathic features; the proportion experiencing significant, long-term NeuP, and the proportion not responding to standard treatment are unknown. These " refractory" cases are the most clinically important to detect, being the most severe, requiring specialist treatment.Methods: We report an international Delphi survey of experts in NeuP, aiming for consensus on the features required to define, for epidemiological research: (1) neuropathic pain; and (2) when NeuP is " refractory" . A web-based questionnaire was developed and data collected from three rounds of questionnaires from nineteen experts.Results: There was good consensus on essential inclusion of six items to identify NeuP (" prickling, tingling, pins & needles" , " pain evoked by light touch" , " electric shocks or shooting pain" , " hot or burning" pain, " brush allodynia on self-examination" , and " relevant history" ) and on some items that were non-essential. Consensus was also reached on components of a " refractory NeuP" definition: minimum duration (one year); number of trials of drugs of known effectiveness (four); adequate duration of these trials (three months / maximum tolerated); outcomes of treatment (pain severity, quality of life). Further work needs to validate these proposed criteria in general population research.Conclusions: This paper presents an international consensus on measuring the epidemiology of refractory neuropathic pain. This will be valuable in reaching an agreed estimate of the prevalence of neuropathic pain, and the first estimate of refractory neuropathic pain prevalence.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2012 Smith et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
Keywords: | Delphi method; Epidemiology; Neuropathic pain; Refractory; Web-based questionnaire |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Health Sciences (Leeds) > Academic Unit of Primary Care (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 16 Oct 2014 09:41 |
Last Modified: | 07 Dec 2022 15:21 |
Published Version: | http://dx.doi.org/10.1186/1471-2377-12-29 |
Status: | Published |
Publisher: | BioMed Central |
Identification Number: | 10.1186/1471-2377-12-29 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:80624 |