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Grieve S, Brunner F, Cabral DF, Connett R, Hirata H, Iwasaki N, Nakagawa Y, Sagir A, Sousa G, Vatine JJ, Vaughan-Spickers N, Xu J, Buckle L, McCabe C. An international study to explore the feasibility of collecting standardised outcome data for Complex Regional Pain Syndrome: recommendations for an international clinical research registry. Br J Pain 2023; 17:468-478. [PMID: 38107759 PMCID: PMC10722111 DOI: 10.1177/20494637231188333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2023] Open
Abstract
Introduction Complex Regional Pain Syndrome (CRPS) is a persistent pain condition with low prevalence. Multi-centre collaborative research is needed to attain sufficient sample sizes for meaningful studies. This international observational study: (1) tested the feasibility and acceptability of collecting outcome data using an agreed core measurement set (2) tested and refined an electronic data management system to collect and manage the data. Methods Adults with CRPS, meeting the Budapest diagnostic clinical criteria, were recruited to the study from 7 international research centres. After informed consent, a questionnaire comprising the core set outcome measures was completed: on paper at baseline (T1), and at 3 or 6 months (T2) using a paper or e-version. Participants and clinicians provided feedback on the data collection process. Clinicians completed the CRPS severity score at T1 and optionally, at T2. Ethical approval was obtained at each international centre. Results Ninety-eight adults were recruited (female n=66; mean age 46.6 years, range 19-89), of whom 32% chose to receive the T2 questionnaire in an electronic format. Fifty-five participants completed both T1 and T2. Eighteen participants and nine clinicians provided feedback on their data collection experience. Conclusion This study confirmed the questionnaire core outcome data are feasible and practicable to collect in clinical practice. The electronic data management system provided a robust means of collecting and managing the data across an international population. The findings have informed the final data collection tools and processes which will comprise the first international, clinical research registry and data bank for CRPS.
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Affiliation(s)
- Sharon Grieve
- Royal United Hospitals Bath NHS Foundation Trust, Bath, UK
- University of the West of England, Bristol, UK
| | | | - Danylo F Cabral
- University of Miami Miller School of Medicine, Miami, Florida, USA
| | | | | | | | | | - Afrin Sagir
- Cleveland Clinic, Cleveland, Ohio, USA
- University of Pennsylvania, Philadelphia, USA
| | | | - Jean-Jacques Vatine
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Reuth Rehabilitation Hospital, Tel Aviv, Israel
| | | | - Jijun Xu
- Cleveland Clinic, Cleveland, Ohio, USA
| | - Lisa Buckle
- Royal United Hospitals Bath NHS Foundation Trust, Bath, UK
- University of the West of England, Bristol, UK
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Harden RN, McCabe CS, Goebel A, Massey M, Suvar T, Grieve S, Bruehl S. Complex Regional Pain Syndrome: Practical Diagnostic and Treatment Guidelines, 5th Edition. PAIN MEDICINE (MALDEN, MASS.) 2022; 23:S1-S53. [PMID: 35687369 PMCID: PMC9186375 DOI: 10.1093/pm/pnac046] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 03/15/2022] [Indexed: 11/23/2022]
Abstract
There have been some modest recent advancements in the research of Complex Regional Pain Syndrome, yet the amount and quality of the work in this complicated multifactorial disease remains low (with some notable exceptions; e.g., the recent work on the dorsal root ganglion stimulation). The semi-systematic (though in some cases narrative) approach to review is necessary so that we might treat our patients while waiting for "better research." This semi-systematic review was conducted by experts in the field, (deliberately) some of whom are promising young researchers supplemented by the experience of "elder statesman" researchers, who all mention the system they have used to examine the literature. What we found is generally low- to medium-quality research with small numbers of subjects; however, there are some recent exceptions to this. The primary reason for this paucity of research is the fact that this is a rare disease, and it is very difficult to acquire a sufficient sample size for statistical significance using traditional statistical approaches. Several larger trials have failed, probably due to using the broad general diagnostic criteria (the "Budapest" criteria) in a multifactorial/multi-mechanism disease. Responsive subsets can often be identified in these larger trials, but not sufficient to achieve statistically significant results in the general diagnostic grouping. This being the case the authors have necessarily included data from less compelling protocols, including trials such as case series and even in some instances case reports/empirical information. In the humanitarian spirit of treating our often desperate patients with this rare syndrome, without great evidence, we must take what data we can find (as in this work) and tailor a treatment regime for each patient.
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Affiliation(s)
- R Norman Harden
- Departments of PM&R and Physical Therapy and Human Movement Sciences, Northwestern University
| | - Candida S McCabe
- University of the West of England, Stapleton, Bristol, UK
- Dorothy House Hospice, Bradford-on-Avon, Wilts, UK
| | - Andreas Goebel
- Pain Research Institute, Faculty of Health and Life Science, University of Liverpool, Liverpool, UK
| | - Michael Massey
- CentraCare Neurosciences Pain Center, CentraCare, St. Cloud, Minnesota, USA
| | - Tolga Suvar
- Department of Anesthesiology and Pain Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Sharon Grieve
- Royal United Hospitals Bath NHS Foundation Trust, Bath, UK
| | - Stephen Bruehl
- Department of Anesthesiology, Vanderbilt University Medical Centers, Nashville, Tennessee, USA
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Grieve S, Brunner F, Buckle L, Gobeil F, Hirata H, Iwasaki N, Moseley L, Sousa G, Vatine JJ, Vaughan-Spickers N, Xu J, McCabe C. A multi-centre study to explore the feasibility and acceptability of collecting data for complex regional pain syndrome clinical studies using a core measurement set: Study protocol. Musculoskeletal Care 2019; 17:249-256. [PMID: 31297959 DOI: 10.1002/msc.1408] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 05/04/2019] [Indexed: 11/10/2022]
Abstract
OBJECTIVES This international, multicentre study will inform the final data collection tools and processes which will comprise the first international, clinical research registry for complex regional pain syndrome (CRPS). This study will: (a) test the feasibility and acceptability of collecting outcome measurement data using a patient reported, questionnaire core measurement set (COMPACT [Core Outcome Measurement set for complex regional PAin syndrome Clinical sTudies]); and (b) test and refine an electronic data management system to collect and manage the data. METHODS A maximum of 240 adults, meeting the Budapest diagnostic clinical criteria for CRPS type I or II, will be recruited across eight countries. The COMPACT questionnaire will be completed on two occasions: at baseline (T1) and 6 months later (T2). At T2, participants will choose to complete COMPACT using a paper or electronic version. Participants will be asked to feed back on their experience of completing COMPACT via a questionnaire. A separate questionnaire will ask clinicians to feed back their experience of data collection. ANALYSIS The study is not aiming to derive statistically significant data but to ascertain the practicalities of collecting data, using the COMPACT questionnaire set, across a range of different cultures and populations. At the end of the study, a single workshop will be convened to review the findings and agree the final documents and processes for the international registry.
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Affiliation(s)
- Sharon Grieve
- Royal United Hospitals Bath NHS Foundation Trust, Bath, UK
- University of the West of England, Bristol, UK
| | | | - Lisa Buckle
- Royal United Hospitals Bath NHS Foundation Trust, Bath, UK
- University of the West of England, Bristol, UK
| | | | | | | | | | | | - Jean-Jacques Vatine
- Sackler Faculty of Medicine, Tel Aviv University, Israel
- Reuth Rehabilitation Hospital, Tel Aviv, Israel
| | | | - Jijun Xu
- Cleveland Clinic, Cleveland, Ohio
| | - Candida McCabe
- Royal United Hospitals Bath NHS Foundation Trust, Bath, UK
- University of the West of England, Bristol, UK
- The Florence Nightingale Foundation, London, UK
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Llewellyn A, McCabe C, Hibberd Y, White P, Davies L, Marinus J, Perez R, Thomassen I, Brunner F, Sontheim C, Birklein F, Schlereth T, Goebel A, Haigh R, Connett R, Maihöfner C, Knudsen L, Harden R, Zyluk A, Shulman D, Small H, Gobeil F, Moskovitz P. Are you better? A multi-centre study of patient-defined recovery from Complex Regional Pain Syndrome. Eur J Pain 2017; 22:551-564. [PMID: 29194871 DOI: 10.1002/ejp.1138] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2017] [Indexed: 11/07/2022]
Affiliation(s)
- A. Llewellyn
- Royal United Hospitals; Bath UK
- University of the West of England; Bristol UK
| | - C.S. McCabe
- Royal United Hospitals; Bath UK
- University of the West of England; Bristol UK
| | | | - P. White
- University of the West of England; Bristol UK
| | | | - J. Marinus
- Leiden University Medical Centre; Leiden The Netherlands
| | | | - I. Thomassen
- Dutch National CRPS Patient Organization; Nijmegen The Netherlands
| | - F. Brunner
- Balgrist University Hospital; Zurich Switzerland
| | - C. Sontheim
- Balgrist University Hospital; Zurich Switzerland
| | - F. Birklein
- University Medical Centre Mainz; Mainz Germany
| | - T. Schlereth
- University Medical Centre Mainz; Mainz Germany
- DKD HELIOS Klinik; Wiesbaden Germany
| | - A. Goebel
- Walton Centre NHS Foundation Trust and Pain Research Institute; University of Liverpool; Liverpool UK
| | - R. Haigh
- Royal Devon & Exeter Hospital; Exeter UK
| | - R. Connett
- Royal Devon & Exeter Hospital; Exeter UK
| | - C. Maihöfner
- Department of Neurology; General Hospital Fürth; Fürth Germany
| | - L. Knudsen
- The Spinal Cord Injury Centre of Western Denmark; Viborg Regional Hospital; Viborg Denmark
- Danish Pain Research Centre; Aarhus University Hospital; Aarhus Denmark
| | - R.N. Harden
- Rehabilitation Institute of Chicago; Chicago IL USA
| | - A. Zyluk
- Pomeranian Medical University; Szczecin Poland
| | - D. Shulman
- Markham-Stouffville Hospital; Markham ON Canada
| | - H. Small
- PARC (Promoting Awareness of RSD and CRPS in Canada); St. Catharines Canada
| | - F. Gobeil
- CSSS Pierre Boucher; Longueuil QC Canada
| | - P. Moskovitz
- The George Washington University Hospital; Washington DC USA
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[External validity of pain-linked functional interference: are we measuring what we want to measure?]. Schmerz 2013; 26:396-401. [PMID: 22729803 DOI: 10.1007/s00482-012-1154-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
BACKGROUND Measurement of functional interference (FI) of pain is crucial for postoperative pain management. This study examined the external validity of three FI items (respiration, mobilization and sleep) within the framework of the German quality improvement in postoperative pain management (QUIPS) project. MATERIAL AND METHODS A total of 380 patients undergoing trauma/orthopedic or abdominal surgery were asked to complete the QUIPS outcome questionnaire. Criteria to determine external validity of FI assessment were tolerance to a continuous passive motion (CPM) machine for FI with mobilization, the pre-postoperative difference of peak flow for FI with respiration and sleep quality measured with actigraphy for FI with sleep. RESULTS The QUIPS outcome questionnaire achieved satisfactory reliability (r(tt) =0 .783-0.954, internal consistency 0.597-0.941). The three FI items under examination achieved a significant correlation (r =0 .407-0.469) with the external criteria.
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Packham T, MacDermid JC, Henry J, Bain J. A systematic review of psychometric evaluations of outcome assessments for complex regional pain syndrome. Disabil Rehabil 2011; 34:1059-69. [DOI: 10.3109/09638288.2011.626835] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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