Tests for central sensitization in general practice: a Delphi study.

Chronic pain and persistent physical symptoms remain poorly understood in general practice. Existing evidence suggests that central sensitization could contribute to symptom persistence. Prior research has identified potential diagnostic tools, but their suitability for routine use remains unclear. No prior work had resolved how to translate these findings into practical assessments. This gap motivated a systematic review of available tests. That uncertainty drove the need to evaluate feasibility and added value in real-world settings. It was already known that diagnostic tools must align with clinical workflows. No prior work had resolved how to prioritize tests for general practice. This gap motivated the current study.

The aim was to identify which tests for central sensitization could be used in general practice. The specific problem is the lack of validated diagnostic tools for central sensitization in primary care. The motivation comes from the need to improve diagnostic accuracy for chronic pain patients. No prior work had resolved which tests are both feasible and valuable in this setting. That uncertainty drove the decision to use a Delphi study with expert consensus. The goal was to assess technical feasibility and added value. No prior work had resolved how to translate research into clinical practice. This gap motivated the current approach.

The study used a Delphi method involving two rounds of expert consultation. Experts were selected from chronic pain and persistent physical symptoms fields. A total of 27 experts participated in the study. The researchers compiled a list of 15 potential tests from prior literature. Panellists rated each test on feasibility and added value. Ratings were collected via email over two rounds. Consensus was defined as agreement from 70% of participants. Three tests were included after reaching consensus.

The study identified three tests suitable for general practice: CSI, PPTs, and monofilaments. The Central Sensitization Inventory showed high feasibility and added value. Pressure pain thresholds were rated as technically feasible in primary care. Monofilaments were also considered suitable for routine use. No consensus was reached on the Sensory Hypersensitivity Scale. Eleven other tests were excluded due to low feasibility or added value. The Delphi process allowed for structured expert opinion gathering. Final results reflect a balance between clinical utility and practicality.

The authors concluded that three tests are suitable for general practice: CSI, PPTs, and monofilaments. These findings suggest that central sensitization can be assessed in primary care settings. The Delphi method provided a structured way to gather expert consensus. No prior work had resolved which tests are most practical for clinicians. The results reflect a balance between diagnostic accuracy and workflow. The authors propose that these tests could improve diagnostic clarity for patients. No prior work had resolved how to implement these findings in practice. These conclusions align with the study’s aim to support clinical use.