Development of a Central Sensitization Inventory short form using data from twenty-three countries.

Area of Science:

• Pain Medicine
• Psychometrics
• Clinical Assessment

Background:

• The 25-item Central Sensitization Inventory (CSI-25) measures central sensitization symptoms but its length can hinder large-scale studies and routine practice.
• Developing a shorter, validated version is crucial for broader clinical and research application.

Purpose of the Study:

• To develop and validate a brief, 7-item version of the Central Sensitization Inventory (CSI-7).
• To ensure the CSI-7 is a psychometrically sound and efficient tool for assessing central sensitization symptoms internationally.

Main Methods:

• A large international sample (N=7,862) across 23 countries was used for development.
• Multi-step Rasch analysis identified optimal items, followed by expert review for face-content validity.
• The CSI-7 was validated through internal consistency, discriminative validity, and Receiver Operating Characteristic (ROC) curve analysis.

Main Results:

• The 7-item CSI (CSI-7) demonstrated excellent fit to a unidimensional model.
• Internal consistency was adequate (CSI-7: α=0.85, ω=0.85).
• The CSI-7 showed strong discriminative validity, with scores increasing across conditions from healthy controls to fibromyalgia, and excellent accuracy (AUC=0.98) in differentiating fibromyalgia from healthy controls.

Conclusions:

• The CSI-7 is an efficient, unidimensional, and internally consistent alternative to the CSI-25.
• It serves as a brief, clinically useful screening tool for central sensitization symptoms across diverse pain conditions.
• The CSI-7 reduces patient burden while retaining psychometric rigor for international use in clinical and research settings.