Key result
Quantitative sensory testing shows moderate to excellent rater reliability for heat and pressure pain thresholds.
Why the study?
Quantitative sensory testing can predict trauma outcomes, but the reliability of multiple modalities—including temporal summation, thermal, and pressure pain thresholds—is unknown.
What is the intra- and inter-rater reliability of quantitative sensory testing in asymptomatic and acute musculoskeletal trauma populations?
Observational (n=46)
What is the intra- and inter-rater reliability of quantitative sensory testing in asymptomatic and acute musculoskeletal trauma populations?
Quantitative sensory testing demonstrates moderate to excellent reliability for heat and pressure pain thresholds in both healthy and musculoskeletal trauma populations, supporting its use in evaluating sensory function.
Answers are grounded in this paper and cite their sources.
Supports QST reliability in trauma research; leaves open clinical adoption pending prospective validation.
Traumatic injuries affect approximately 978 million people worldwide with 56.2 million requiring inpatient care. Quantitative sensory testing (QST) can be useful in predicting outcome following trauma, however the reliability of multiple QST including temporal summation (TS), heat and cold pain thresholds (HPT, CPT) and pressure pain thresholds (PPT) is unknown. We assessed intra (between day) and inter-rater (within day) reliability of QST in asymptomatic participants (n = 21), and inter-rater (within day) reliability in participants presenting with acute musculoskeletal trauma (n = 25). Intra-class correlations with 95% confidence intervals (ICC 3,2), standard error of measurement (SEM) and Bland Altman Plots for limits of agreement were calculated. For asymptomatic participants, reliability was good to excellent for HPT (ICC range 0.76-0.95), moderate to good for PPT (ICC range 0.52-0.93), with one site rated poor (ICC 0.41), and poor to excellent for TS scores (ICC range 0.20-0.91). For musculoskeletal trauma participants reliability was good to excellent for HPT and PPT (ICC range 0.76-0.86), and moderate to good reliability for TS (ICC range 0.69-0.91). SEM for HPT for both sets of participants was ~1°C and an average of 7N for asymptomatic participants and less than 8N for acute musculoskeletal trauma participants for PPT. This study demonstrates moderate to excellent intra and inter-rater reliability for HPT and PPT in asymptomatic participants and good to excellent inter-rater reliability for acute musculoskeletal trauma participants, with TS showing more variability for both sets of participants. This study provides foundations for future work evaluating the sensory function over time following acute musculoskeletal trauma.
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Middlebrook et al. (2020) conducted an observational in Healthy cohort and acute musculoskeletal trauma (n=46). Quantitative sensory testing (QST) was evaluated on Intra- and inter-rater reliability (ICC) of QST measures. Quantitative sensory testing demonstrated moderate to excellent intra- and inter-rater reliability for heat and pressure pain thresholds in asymptomatic and acute musculoskeletal trauma participants.
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