Modified S-LANSS not accurate for recognition of neuropathic orofacial pain conditions

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Modified S-LANSS not accurate for recognition of neuropathic orofacial pain conditions

Neuropathic orofacial pain can be distressing and affect the overall quality of life. Neuropathic pain can be episodic like trigeminal neuralgias, or continuous, like peripheral painful trigeminal traumatic neuropathy, persistent idiopathic facial pain, neuritis, and burning mouth syndrome.

 In this study,  the accuracy of a questionnaire modified for the identification of intraoral pain with neuropathic characteristics in a clinical orofacial pain sample population was estimated.

A total of 136 participants with at least one of four orofacial pain diagnoses (temporomandibular disorders [TMD, n=41], acute dental pain [ADP, n=41], trigeminal neuralgia [TN, n=19], persistent dentoalveolar pain disorder [PDAP, n=14]) and a group of pain-free controls (n=21) completed the modified S-LANSS. A formerly adapted version of the original questionnaire devised to detected patients suffering from intraoral pain with neuropathic characteristics. The psychometric properties (sensitivity, specificity, positive predictive value;PPV, negative predictive value;NPV) were determined in two analyses with two different thresholds: (1) Detection of pain with neuropathic characteristics: PDAP + TN were considered positive, and TMD + ADP + controls were considered negative per gold standard (expert opinion).

Persistent dentoalveolar pain disorder was considered positive and TMD + ADP were considered negative per gold standard. For both analyses, target values for reasonable sensitivity and specificity was defined as ≥ 80%.

As per the results, for the revelation of orofacial pain with neuropathic characteristics (PDAP + TN), the modified S-LANSS showed the most optimistic threshold sensitivity of 52% (95% confidence interval [CI], 34-69), specificity of 70% (95% CI, 60-79), PPV of 35% (95% CI, 22-51), and NPV of 82% (95% CI, 72-89). For detection of PDAP only, with the most promising threshold sensitivity was 64% (95% CI, 35-87), specificity 63% (95% CI, 52-74), PPV 23% (95% CI, 11-39) and NPV 91% (95% CI, 81-97).

It was thus concluded, that based on a priori defined criteria, the modified S-LANSS did not show adequate accuracy to detect intraoral pain with neuropathic characteristics in a clinical orofacial pain sample.

Source:

Quintessence Int.

Link to the source:

https://www.ncbi.nlm.nih.gov/pubmed/27981266

Original title of article:

Initial accuracy assessment of the modified S-LANSS for the detection of neuropathic orofacial pain conditions.

Authors:

Herrero Babiloni A. et al.

Quintessence Int.
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