Validation of proposed diagnostic criteria (the "Budapest Criteria") for Complex Regional Pain Syndrome.
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.
Harden
Norman R
NR
Rehabilitation Institute of Chicago, Chicago, IL, USA Vanderbilt University School of Medicine, Nashville, TN, USA VU University Medical Center, Amsterdam, The Netherlands Trauma Related Neuronal Dysfunction Consortium (TREND), Leiden University Medical Center, Leiden, The Netherlands University Medical Center Mainz, Mainz, Germany Leiden University Medical Center, Leiden, The Netherlands University of Erlangen-Nuremberg, Erlangen, Germany Rush University Medical Center, Chicago, IL, USA Stanford University Medical Center, Stanford, CA, USA Reuth Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Bruehl
Stephen
S
Perez
Roberto S G M
RSGM
Birklein
Frank
F
Marinus
Johan
J
Maihofner
Christian
C
Lubenow
Timothy
T
Buvanendran
Asokumar
A
Mackey
Sean
S
Graciosa
Joseph
J
Mogilevski
Mila
M
Ramsden
Christopher
C
Chont
Melissa
M
Vatine
Jean-Jacques
JJ
D020918:Complex Regional Pain Syndromes / Q000175:diagnosis*; D016208:Databases, Factual; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D010147:Pain Measurement; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity