Measurement properties of painDETECT: Rasch analysis of responses from community-dwelling adults with neuropathic pain

BMC Neurology, 2017 · DOI: 10.1186/s12883-017-0825-2 · Published: March 15, 2017

Pain Management Research Methodology & Design

Simple Explanation

This study used Rasch analysis to examine the measurement properties of the painDETECT (PD-Q) questionnaire, a tool used to screen for neuropathic pain. Rasch analysis helps determine if the questionnaire's scoring and measurement are consistent and reliable. The study found that after some adjustments, a seven-item version of the PD-Q showed good reliability. This suggests that these seven items could be used to measure pain outcomes in research and clinical practice. The findings indicate that the modified PD-Q can provide a consistent and accurate way to assess neuropathic pain qualities, potentially improving the monitoring and management of pain over time.

Study Duration

Not specified

Participants

624 persons with a diagnosis of painful diabetic polyneuropathy, small fibre neuropathy, and neuropathic pain associated with chronic low back pain, spinal cord injury, HIV-related pain, or chronic post-surgical pain

Evidence Level

Not specified

Key Findings

1
PD-Q demonstrated fit to the Rasch model after adjustments of scoring categories for four items, and omission of the time course and radiating questions.
2
The resulting seven-item scale of pain qualities demonstrated good reliability with a person-separation index of 0.79.
3
No scoring bias (differential item functioning) was found for this version.

Research Summary

The study aimed to evaluate the measurement properties of painDETECT (PD-Q) using Rasch analysis to determine its suitability as an outcome measure for neuropathic pain (NeP). The analysis involved data from 624 patients with various NeP conditions, and adjustments were made to scoring categories and item inclusion to improve model fit. The results supported a seven-item version of PD-Q as a reliable and valid outcome measure for assessing pain qualities in NeP, with potential for use in clinical and research settings.

Practical Implications

Clinical Practice

The seven-item PD-Q, with rescoring, can be used to track changes in pain qualities over time, aiding in clinical decision-making.

Research

The modified PD-Q can serve as a reliable outcome measure in clinical trials, reducing the burden of measurement by combining screening and outcome tracking.

Scale Development

Future research should focus on developing a Rasch scoring conversion table to transform ordinal PD-Q scores into interval-level scores for accurate longitudinal monitoring.

Study Limitations

1
Selection bias inherent in the initial data collection for the NeP survey may influence PD-Q scores.
2
RUMM2030 software restrictions limit the number of person-level factors used to describe participants, potentially overlooking DIF related to other characteristics.
3
The large sample size may be powered to find very small differences, making the target of a non-significant chi-square value for item-trait interaction increasingly stringent.

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