Sensory bedside testing: a simple stratification approach for sensory phenotyping
Maren Reimer, Julia Forstenpointner, Alina Hartmann, Jan Carl Otto, Jan Vollert, Janne Gierthmühlen, Thomas Klein, Philipp Hüllemann, Ralf Baron
Abstract
INTRODUCTION: Stratification of patients according to the individual sensory phenotype has been suggested a promising method to identify responders for pain treatment. However, many state-of-the-art sensory testing procedures are expensive or time-consuming. OBJECTIVES: Therefore, this study aimed to present a selection of easy-to-use bedside devices. METHODS: In total, 73 patients (39 m/34 f) and 20 controls (11 m/9 f) received a standardized laboratory quantitative sensory testing (QST) and a bedside-QST. In addition, 50 patients were tested by a group of nonexperienced investigators to address the impact of training. The sensitivity, specificity, and receiver-operating characteristics were analyzed for each bedside-QST parameter as compared to laboratory QST. Furthermore, the patients' individual sensory phenotype (ie, cluster) was determined using laboratory QST, to select bedside-QST parameters most indicative for a correct cluster allocation. RESULTS: 70%). Results of interrater variability indicated that training is necessary for individual parameters (ie, CMS 0.7). For the cluster assessment, the respective bedside quantitative sensory testing (QST) parameter combination indicated the following agreements as compared to laboratory QST stratification: excellent for "sensory loss" (area under the curve [AUC] = 0.91), good for "thermal hyperalgesia" (AUC = 0.83), and fair for "mechanical hyperalgesia" (AUC = 0.75). CONCLUSION: This study presents a selection of bedside parameters to identify the individual sensory phenotype as cost and time efficient as possible.