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International Spinal Cord Injury Pain (ISCIP) Classification: Part 2. Initial validation using vignettes
T N Bryce1, F Biering-Sørensen, N B Finnerup
1Department of Rehabilitation Medicine, Mount Sinai School of Medicine, New York, NY 10029, USA. thomas.bryce@mssm.edu
Spinal Cord
|February 8, 2012
Summary
The International Spinal Cord Injury Pain (ISCIP) Classification showed moderate reliability among clinicians using vignettes. Some pain subtypes were challenging, indicating a need for further testing on actual patients with spinal cord injury pain.
Area of Science:
- Pain research
- Clinical classification systems
- Spinal cord injury (SCI) medicine
Background:
- The International Spinal Cord Injury Pain (ISCIP) Classification aims to standardize pain assessment in SCI patients.
- Evaluating the reliability of this classification tool among clinicians is crucial for its effective implementation.
Purpose of the Study:
- To investigate the utility and reliability of the ISCIP Classification when used by clinicians.
- To assess clinician accuracy in identifying pain components and types using the ISCIP Classification.
Main Methods:
- An international validation study utilized self-administered Internet surveys.
- Seventy-five clinical vignettes, developed by ISCIP Classification group members, were presented to clinicians.
- Clinicians classified pain components and types based on the ISCIP Classification for each vignette.
Main Results:
- Clinicians demonstrated moderate accuracy in classifying pain types, with overall correctness ranging from 68% (strict criteria) to 85% (relaxed criteria).
- Accuracy varied by pain subtype, with neuropathic at-level SCI pain (57%) and below-level SCI pain (73%) being more challenging than others.
- Average respondent correctness for identifying the number of pain components was 86%.
Conclusions:
- The ISCIP Classification exhibits moderate reliability among clinicians with minimal training, as assessed via clinical vignettes.
- Certain pain subtypes present classification challenges, suggesting a need for refinement or further training.
- Future reliability testing should involve direct application to individuals with SCI pain, and classification instructions have been clarified based on this study.
