Analysis of quantitative sudomotor axon reflex test patterns in patients with complex regional pain syndrome diagnosed using the Budapest criteria

Ho Jin Lee, Se Eun Kim, Jeeyoun Moon, Je Young Shin, Yong Chul Kim

Research output: Contribution to journalArticle

Abstract

Background Although the quantitative sensory axon reflex test (QSART) is used to evaluate sudomotor dysfunction in the diagnosis of complex regional pain syndrome (CRPS), its validity remains controversial. This study investigated the diagnostic performance of the QSART for CRPS and assessed associations between results of the QSART and other clinical variables. Methods We examined the electronic medical records of 196 consecutive patients who underwent the QSART with a suspected diagnosis of CRPS, during the period from January 2013 to December 2015. To assess the diagnostic performance of the QSART for CRPS based on the Budapest research criteria, we calculated sensitivity, specificity, positive likelihood ratio and negative likelihood ratio. Furthermore, we performed binary logistic regression analyses to investigate the relationships between QSART results and other clinical variables. Results The sensitivity and specificity of the QSART for diagnosing CRPS were 67.6% and 40.6%, respectively. The OR for diagnosing CRPS using the QSART was not statistically significant (1.43; 95% CI 0.65 to 3.14; p=0.376), whereas it was for distinguishing CRPS types I and II (4.11; 95% CI 1.34 to 12.57; p=0.013). In multivariable analysis, there were no correlations between the results of the QSART and other variables, except hypertension (OR=0.34; 95% CI 0.13 to 0.91; p=0.032). Conclusion The QSART showed low diagnostic value as a screening or a confirmatory test for CRPS according to the Budapest research criteria. CRPS type II was more likely than CRPS type I to result in abnormal QSART results.

Original languageEnglish
Pages (from-to)1026-1032
Number of pages7
JournalRegional Anesthesia and Pain Medicine
Volume44
Issue number11
DOIs
StatePublished - 1 Nov 2019

Fingerprint

Complex Regional Pain Syndromes
Axons
Reflex
Reflex Sympathetic Dystrophy
Sensitivity and Specificity
Electronic Health Records
Research

Keywords

  • chronic pain: complex regional pain syndrome
  • chronic pain: diagnostic pain procedures
  • chronic pain: neuropathic pain
  • chronic pain: sympathetic blocks

Cite this

@article{17b5fb7cef8e473b9b3c23ee3f131f02,
title = "Analysis of quantitative sudomotor axon reflex test patterns in patients with complex regional pain syndrome diagnosed using the Budapest criteria",
abstract = "Background Although the quantitative sensory axon reflex test (QSART) is used to evaluate sudomotor dysfunction in the diagnosis of complex regional pain syndrome (CRPS), its validity remains controversial. This study investigated the diagnostic performance of the QSART for CRPS and assessed associations between results of the QSART and other clinical variables. Methods We examined the electronic medical records of 196 consecutive patients who underwent the QSART with a suspected diagnosis of CRPS, during the period from January 2013 to December 2015. To assess the diagnostic performance of the QSART for CRPS based on the Budapest research criteria, we calculated sensitivity, specificity, positive likelihood ratio and negative likelihood ratio. Furthermore, we performed binary logistic regression analyses to investigate the relationships between QSART results and other clinical variables. Results The sensitivity and specificity of the QSART for diagnosing CRPS were 67.6{\%} and 40.6{\%}, respectively. The OR for diagnosing CRPS using the QSART was not statistically significant (1.43; 95{\%} CI 0.65 to 3.14; p=0.376), whereas it was for distinguishing CRPS types I and II (4.11; 95{\%} CI 1.34 to 12.57; p=0.013). In multivariable analysis, there were no correlations between the results of the QSART and other variables, except hypertension (OR=0.34; 95{\%} CI 0.13 to 0.91; p=0.032). Conclusion The QSART showed low diagnostic value as a screening or a confirmatory test for CRPS according to the Budapest research criteria. CRPS type II was more likely than CRPS type I to result in abnormal QSART results.",
keywords = "chronic pain: complex regional pain syndrome, chronic pain: diagnostic pain procedures, chronic pain: neuropathic pain, chronic pain: sympathetic blocks",
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Analysis of quantitative sudomotor axon reflex test patterns in patients with complex regional pain syndrome diagnosed using the Budapest criteria. / Lee, Ho Jin; Kim, Se Eun; Moon, Jeeyoun; Shin, Je Young; Kim, Yong Chul.

In: Regional Anesthesia and Pain Medicine, Vol. 44, No. 11, 01.11.2019, p. 1026-1032.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Analysis of quantitative sudomotor axon reflex test patterns in patients with complex regional pain syndrome diagnosed using the Budapest criteria

AU - Lee, Ho Jin

AU - Kim, Se Eun

AU - Moon, Jeeyoun

AU - Shin, Je Young

AU - Kim, Yong Chul

PY - 2019/11/1

Y1 - 2019/11/1

N2 - Background Although the quantitative sensory axon reflex test (QSART) is used to evaluate sudomotor dysfunction in the diagnosis of complex regional pain syndrome (CRPS), its validity remains controversial. This study investigated the diagnostic performance of the QSART for CRPS and assessed associations between results of the QSART and other clinical variables. Methods We examined the electronic medical records of 196 consecutive patients who underwent the QSART with a suspected diagnosis of CRPS, during the period from January 2013 to December 2015. To assess the diagnostic performance of the QSART for CRPS based on the Budapest research criteria, we calculated sensitivity, specificity, positive likelihood ratio and negative likelihood ratio. Furthermore, we performed binary logistic regression analyses to investigate the relationships between QSART results and other clinical variables. Results The sensitivity and specificity of the QSART for diagnosing CRPS were 67.6% and 40.6%, respectively. The OR for diagnosing CRPS using the QSART was not statistically significant (1.43; 95% CI 0.65 to 3.14; p=0.376), whereas it was for distinguishing CRPS types I and II (4.11; 95% CI 1.34 to 12.57; p=0.013). In multivariable analysis, there were no correlations between the results of the QSART and other variables, except hypertension (OR=0.34; 95% CI 0.13 to 0.91; p=0.032). Conclusion The QSART showed low diagnostic value as a screening or a confirmatory test for CRPS according to the Budapest research criteria. CRPS type II was more likely than CRPS type I to result in abnormal QSART results.

AB - Background Although the quantitative sensory axon reflex test (QSART) is used to evaluate sudomotor dysfunction in the diagnosis of complex regional pain syndrome (CRPS), its validity remains controversial. This study investigated the diagnostic performance of the QSART for CRPS and assessed associations between results of the QSART and other clinical variables. Methods We examined the electronic medical records of 196 consecutive patients who underwent the QSART with a suspected diagnosis of CRPS, during the period from January 2013 to December 2015. To assess the diagnostic performance of the QSART for CRPS based on the Budapest research criteria, we calculated sensitivity, specificity, positive likelihood ratio and negative likelihood ratio. Furthermore, we performed binary logistic regression analyses to investigate the relationships between QSART results and other clinical variables. Results The sensitivity and specificity of the QSART for diagnosing CRPS were 67.6% and 40.6%, respectively. The OR for diagnosing CRPS using the QSART was not statistically significant (1.43; 95% CI 0.65 to 3.14; p=0.376), whereas it was for distinguishing CRPS types I and II (4.11; 95% CI 1.34 to 12.57; p=0.013). In multivariable analysis, there were no correlations between the results of the QSART and other variables, except hypertension (OR=0.34; 95% CI 0.13 to 0.91; p=0.032). Conclusion The QSART showed low diagnostic value as a screening or a confirmatory test for CRPS according to the Budapest research criteria. CRPS type II was more likely than CRPS type I to result in abnormal QSART results.

KW - chronic pain: complex regional pain syndrome

KW - chronic pain: diagnostic pain procedures

KW - chronic pain: neuropathic pain

KW - chronic pain: sympathetic blocks

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U2 - 10.1136/rapm-2019-100415

DO - 10.1136/rapm-2019-100415

M3 - Article

C2 - 31501247

AN - SCOPUS:85072170987

VL - 44

SP - 1026

EP - 1032

JO - Regional anesthesia and pain medicine

JF - Regional anesthesia and pain medicine

SN - 1098-7339

IS - 11

ER -