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RESEARCH PRODUCT

Validation of proposed diagnostic criteria (the "Budapest Criteria") for Complex Regional Pain Syndrome

Jean Jacques VatineMelissa ChontRobert N HardenFrank BirkleinJoseph R. GraciosaSean MackeyTimothy R. LubenowAsokumar BuvanendranChristopher E. RamsdenJohan MarinusChristian MaihöfnerStephen BruehlRoberto S.g.m. PerezRoberto S.g.m. PerezMila Mogilevski

subject

MaleValidation studymedicine.medical_specialtyDatabases FactualSigns and symptomsDiagnostic accuracySensitivity and SpecificityArticleDiagnosis DifferentialmedicineRegional pain syndromeHumansOverdiagnosisPain Measurementbusiness.industryReproducibility of ResultsComplex Regional Pain Syndrome Reflex sympathetic dystrophy CRPS RSD Diagnosis Validation reflex sympathetic dystrophy syndrome type-i signs crpsmedicine.diseaseSurgeryAnesthesiology and Pain MedicineComplex regional pain syndromeNeurologyPhysical therapyFemaleNeurology (clinical)businessComplex Regional Pain Syndromes

description

Current IASP diagnostic criteria for CRPS have low specificity, potentially leading to overdiagnosis. This validation study compared current IASP diagnostic criteria for CRPS to proposed new diagnostic criteria (the "Budapest Criteria") regarding diagnostic accuracy. Structured evaluations of CRPS-related signs and symptoms were conducted in 113 CRPS-I and 47 non-CRPS neuropathic pain patients. Discriminating between diagnostic groups based on presence of signs or symptoms meeting IASP criteria showed high diagnostic sensitivity (1.00), but poor specificity (0.41), replicating prior work. In comparison, the Budapest clinical criteria retained the exceptional sensitivity of the IASP criteria (0.99), but greatly improved upon the specificity (0.68). As designed, the Budapest research criteria resulted in the highest specificity (0.79), again replicating prior work. Analyses indicated that inclusion of four distinct CRPS components in the Budapest Criteria contributed to enhanced specificity. Overall, results corroborate the validity of the Budapest Criteria and suggest they improve upon existing IASP diagnostic criteria for CRPS. (C) 2010 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

yearjournalcountryeditionlanguage
2010-08-31
10.1016/j.pain.2010.04.030https://doi.org/10.1016/j.pain.2010.04.030