Interrater reliability of diagnosing complex regional pain syndrome type I.
BACKGROUND
Diagnosis of complex regional pain syndrome type I (CRPS I) is based on clinical observation of symptoms. As little information is available on the reliability of CRPS I diagnosis, we evaluated the agreement between therapists with regard to the presence and severity of CRPS I and its symptoms.


METHODS
The interrater reliability was evaluated in 37 presumed CRPS I patients by three observers; one consultant anesthesiologist and two resident anesthesiologists. Patients were assessed on the basis of Veldman's CRPS criteria.


RESULTS
The interrater reliability for diagnosing CRPS I was good for the majority of observer combinations. The percentage of agreement for the absence or presence of CRPS I was good (88%-100%). Cohen's Kappa's ranged from 0.60 to 0.86. The agreement for the mean symptom score ranged from 70.2% to 88.6%; Kappa's were lower and showed more variation. Interrater reliability for assessment of the severity of CRPS I and its symptoms was poor. Factors influencing the interrater reliability were symptom type, individual observers and sample population.


CONCLUSIONS
Diagnosing CRPS I can be performed on the basis of clinical observation. Further assessment of severity of CRPS I and its symptoms should be performed with reliable and valid measurement instruments.
Perez
R S G M
RS
Department of Anesthesiology, Vrije Universiteit Medical Center, Amsterdam , The Netherlands. rsgm.perez@vumc.nl
Burm
P E T
PE
Zuurmond
W W A
WW
Giezeman
M J M M
MJ
van Dasselaar
N T
NT
Vranken
J
J
de Lange
J J
JJ
D000328:Adult; D000776:Anesthesiology; D020918:Complex Regional Pain Syndromes / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007396:Internship and Residency; D008297:Male; D015588:Observer Variation; D010147:Pain Measurement