Identification of cut-points for mild, moderate and severe pain due to diabetic peripheral neuropathy
- 1 May 2005
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Pain
- Vol. 115 (1), 29-36
- https://doi.org/10.1016/j.pain.2005.01.028
Abstract
This study identified discrete categories of pain severity in a sample of patients with painful diabetic peripheral neuropathy (DPN), through derivation of cut-points on a 0–10 scale of pain severity (Brief Pain Inventory-DPN, BPI-DPN). Subjects were participants in a burden of illness survey ( N =255). Serlin and colleagues' method establishing cut-points for cancer pain was adapted, considering all possible cut-points between 4 and 8. Optimal cut-points were those that created three pain severity categories producing maximum between-category differences on the seven BPI-DPN Interference items, using MANOVA. Cut-points of 4 and 7 optimally classified the sample for both Worst Pain and Average Pain, creating categories of mild, 0–3; moderate, 4–6; severe, 7 and higher (Hotelling's T 2 =22.95 and 16.20 for Worst and Average Pain, P <0.0001). Mean BPI-DPN Interference was 2.1 (SD=2.1), 4.9 (SD=1.9) and 7.4 (SD=1.6) for the mild, moderate and severe pain categories. Patients in the three categories differed significantly on patient-rated outcomes (Medical Outcomes Study Short Form-12v2 Mental and Physical Component Summaries and EuroQOL utility score), and on DPN-related healthcare visits ( P <0.001). The labels ‘mild, moderate and severe’ Worst and Average Pain corresponded with patients' ratings of their pain using a verbal rating scale. This research shows that three categories of DPN pain severity can be identified based on interference with daily function, and that these categories are associated with patient outcomes and medical utilization.Keywords
This publication has 21 references indexed in Scilit:
- Clinical outcomes measurement: Pain interference in persons with spinal cord injury: Classification of mild, moderate, and severe painThe Journal of Pain, 2004
- Clinical outcomes measurement: Pain severity in diabetic peripheral neuropathy (DPN) impacts patient functioning, symptom levels of anxiety and depression, and sleepThe Journal of Pain, 2004
- Advances in Neuropathic PainArchives of Neurology, 2003
- Defining the clinically important difference in pain outcome measuresPain, 2000
- Painful diabetic polyneuropathy: epidemiology, pain description, and quality of lifeDiabetes Research and Clinical Practice, 2000
- Gabapentin for the Symptomatic Treatment of Painful Neuropathy in Patients With Diabetes MellitusA Randomized Controlled TrialJAMA, 1998
- Modeling Valuations for EuroQol Health StatesMedical Care, 1997
- EuroQol: the current state of playHealth Policy, 1996
- Quality Improvement Guidelines for the Treatment of Acute Pain and Cancer PainJAMA, 1995
- The prevalence by staged severity of various types of diabetic neuropathy, retinopathy, and nephropathy in a population‐based cohortNeurology, 1993