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Korwisi B, Garrido Suárez BB, Goswami S, Gunapati NR, Hay G, Hernández Arteaga MA, Hill C, Jones D, Joshi M, Kleinstäuber M, López Mantecón AM, Nandi G, Papagari CSR, Rabí Martínez MDC, Sarkar B, Swain N, Templer P, Tulp M, White N, Treede RD, Rief W, Barke A. Reliability and clinical utility of the chronic pain classification in the 11th Revision of the International Classification of Diseases from a global perspective: results from India, Cuba, and New Zealand. Pain 2022; 163:e453-e462. [PMID: 34393200 DOI: 10.1097/j.pain.0000000000002379] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 06/11/2021] [Indexed: 11/26/2022]
Abstract
ABSTRACT Chronic pain affects 1 in 5 persons and contributes substantially to the global burden of disease. The 11th Revision of the International Classification of Diseases (ICD-11) includes a comprehensive classification of chronic pain. The aim of this ecological implementation field study was to evaluate the classification's interrater reliability and clinical utility in countries with different income levels. The study was conducted in 4 pain clinics in Cuba, India, and New Zealand. Twenty-one clinicians used the ICD-11 to diagnose and code n = 353 patients with chronic pain. Of these, 111 were assessed by 2 clinicians, and Fleiss' kappa was calculated to establish interrater reliability for any diagnosis assigned to ≥15 patients. The clinicians rated the clinical utility of all diagnoses. The interrater reliability could be calculated for 11 diagnoses. It was substantial for 10 diagnoses and moderate for 1 (kappa: 0.596-0.783). The mean clinical utility of the ICD-11 chronic pain diagnoses was rated as 8.45 ± 1.69/10. Clinical utility was rated higher for ICD-11 than for the commonly used classification systems (P < 0.001, η2 = 0.25) and differed between all centers (P < 0.001, η2 = 0.60). The utility of the ICD-11 diagnoses was rated higher than the commonly used diagnoses in Dunedin and Havana, and no difference was found in Kolkata and Hyderabad. The study showed the high interrater reliability of the new chronic pain diagnoses. The perceived clinical utility of the diagnoses indicates their superiority or equality compared with the classification systems currently used in pain clinics. These results suggest the global applicability of the classification in specialized pain treatment settings.
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Affiliation(s)
- Beatrice Korwisi
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Philipps-University Marburg, Marburg, Germany
| | - Bárbara Beatriz Garrido Suárez
- Department of Pharmacology, Institute of Marine Science (ICIMAR), Havana, Cuba
- Pain Clinic, Hospital 10 de Octubre, Havana, Cuba
| | - Subrata Goswami
- ESI Institute of Pain Management, ESI Hospital Sealdah, Kolkata, India
| | | | - Ginea Hay
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Philipps-University Marburg, Marburg, Germany
| | | | - Charlotte Hill
- Persistent Pain Service, Southern District Health Board, Dunedin Hospital, Dunedin, New Zealand
| | - David Jones
- Persistent Pain Service, Southern District Health Board, Dunedin Hospital, Dunedin, New Zealand
| | | | - Maria Kleinstäuber
- Persistent Pain Service, Southern District Health Board, Dunedin Hospital, Dunedin, New Zealand
- Department of Psychological Medicine, Otago Medical School-Dunedin Campus, University of Otago, Dunedin, New Zealand
| | - Ana Marta López Mantecón
- Pain Clinic, Hospital 10 de Octubre, Havana, Cuba
- Rheumatological Disease Reference Centre, Hospital 10 de Octubre, Havana, Cuba
| | - Gargi Nandi
- ESI Institute of Pain Management, ESI Hospital Sealdah, Kolkata, India
| | | | | | - Biplab Sarkar
- ESI Institute of Pain Management, ESI Hospital Sealdah, Kolkata, India
| | - Nicola Swain
- Department of Psychological Medicine, Otago Medical School-Dunedin Campus, University of Otago, Dunedin, New Zealand
| | - Paul Templer
- Persistent Pain Service, Southern District Health Board, Dunedin Hospital, Dunedin, New Zealand
| | - Maartje Tulp
- Persistent Pain Service, Southern District Health Board, Dunedin Hospital, Dunedin, New Zealand
| | - Naomi White
- Persistent Pain Service, Southern District Health Board, Dunedin Hospital, Dunedin, New Zealand
| | - Rolf-Detlef Treede
- Mannheim Center for Translational Neuroscience (MCTN), Department of Neurophysiology, Medical Faculty Mannheim of Heidelberg University, Mannheim, Germany
| | - Winfried Rief
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Philipps-University Marburg, Marburg, Germany
| | - Antonia Barke
- Division of Clinical and Biological Psychology, Department of Psychology, Catholic University of Eichstätt-Ingolstadt, Ingolstadt, Germany
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