Development and external validation of multivariable risk models to predict incident and resolved neuropathic pain: a DOLORisk Dundee study.
DOLORisk
Epidemiology
Neuropathic pain
Prediction model
Risk factors
Scotland
Validation
Journal
Journal of neurology
ISSN: 1432-1459
Titre abrégé: J Neurol
Pays: Germany
ID NLM: 0423161
Informations de publication
Date de publication:
Feb 2023
Feb 2023
Historique:
received:
28
04
2022
accepted:
04
11
2022
revised:
03
11
2022
pubmed:
11
11
2022
medline:
2
2
2023
entrez:
10
11
2022
Statut:
ppublish
Résumé
Neuropathic pain is difficult to treat, and an understanding of the risk factors for its onset and resolution is warranted. This study aimed to develop and externally validate two clinical risk models to predict onset and resolution of chronic neuropathic pain. Participants of Generation Scotland: Scottish Family Health Study (GS; general Scottish population; n = 20,221) and Genetic of Diabetes Audit and Research in Tayside Scotland (GoDARTS; n = 5236) were sent a questionnaire on neuropathic pain and followed- -up 18 months later. Chronic neuropathic pain was defined using DN4 scores (≥ 3/7) and pain for 3 months or more. The models were developed in GS using logistic regression with backward elimination based on the Akaike information criterion. External validation was conducted in GoDARTS and assessed model discrimination (ROC and Precision-Recall curves), calibration and clinical utility (decision curve analysis [DCA]). Analysis revealed incidences of neuropathic pain onset (6.0% in GS [236/3903] and 10.7% in GoDARTS [61/571]) and resolution (42.6% in GS [230/540] and 23.7% in GoDARTS [56/236]). Psychosocial and lifestyle factors were included in both onset and resolved prediction models. In GoDARTS, these models showed adequate discrimination (ROC = 0.636 and 0.699), but there was evidence of miscalibration (Intercept = - 0.511 and - 0.424; slope = 0.623 and 0.999). The DCA indicated that the models would provide clinical benefit over a range of possible risk thresholds. To our knowledge, these are the first externally validated risk models for neuropathic pain. The findings are of interest to patients and clinicians in the community, who may take preventative or remedial measures.
Identifiants
pubmed: 36355188
doi: 10.1007/s00415-022-11478-0
pii: 10.1007/s00415-022-11478-0
pmc: PMC9886655
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1076-1094Subventions
Organisme : Chief Scientist Office, Scottish Government Health and Social Care Directorate
ID : CZD/16/6
Organisme : Scottish Funding Council
ID : HR03006
Organisme : Horizon 2020 Framework Programme
ID : 633491
Organisme : Wellcome Trust
ID : 072960/Z/03/Z
Pays : United Kingdom
Organisme : Wellcome Trust
ID : 084726/Z/08/Z
Pays : United Kingdom
Organisme : Wellcome Trust
ID : 084727/Z/08/Z
Pays : United Kingdom
Organisme : Wellcome Trust
ID : 085475/Z/08/Z
Pays : United Kingdom
Organisme : Wellcome Trust
ID : 085475/B/08/Z
Pays : United Kingdom
Informations de copyright
© 2022. The Author(s).
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