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在状细胞疾病中疼痛强度测量的比较 血管封闭性发作
Mitchell R Knisely1, Huiman X Barnhart2, Stephanie O Ibemere1
1Duke University School of Nursing, Durham, North Carolina.
The journal of pain
|August 18, 2024
概括
在状细胞病 (SCD) 血管封闭性发作中疼痛的最小临床重要差异 (MCID) 比以前使用视觉模拟量表 (VAS) 和数值评分量表 (NRS) 认为的要低. 这些尺度显示高相关性,但在评估SCD疼痛时不能互换.
科学领域:
- 疼痛管理 疼痛管理
- 血液学 血液学 血液学
- 临床试验 临床试验
背景情况:
- 状细胞病 (SCD) 的急性血管封闭性发作会引起严重的疼痛,需要可靠的疼痛评估工具.
- 视觉模拟量表 (VAS) 和数值评分量表 (NRS) 是常用的,但它们的最小临床重要差异 (MCID) 和在SCD疼痛中的可互换性尚未得到充分证实.
研究的目的:
- 使用VAS和NRS在SCD患者在血管封闭性发作期间确定疼痛严重程度的MCID.
- 评估VAS和NRS之间的协议和可互换性,以此种群体的疼痛测量.
主要方法:
- 在COMPARE-VOE试验中,招募了100名SCD患者,他们在急诊室经历了急性疼痛.
- 参与者每30分钟完成一次VAS,NRS和描述尺度.
- 使用最小疼痛变化的平均差异来计算MCID;使用皮尔森相关性和布兰德-阿尔特曼分析评估一致性.
主要成果:
- 对于VAS的MCID是8.77毫米,对于NRS是8.29.
- VAS和NRS显示出高度的相关性 (r=0.88,P<.001).
- 布兰德-阿尔特曼分析显示出显著的变异性 (平均差异 -4.6 ± 1.96,95%的一致限度 -20至29),表明互换性不佳.
结论:
- 在SCD血管封闭性发作中疼痛的MCID低于以前报告的VAS和NRS.
- 尽管存在很强的相关性,但VAS和NRS在测量SCD疼痛强度时不能互换.
- 这些发现强调了在SCD管理中选择疼痛评估尺度时需要仔细考虑的必要性.
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