title: Cotton-tipped applicator test: validity and reliability in chronic pelvic pain.
abstract: OBJECTIVE
  We sought to assess the concurrent validity and interrater reliability of the cotton-tipped applicator (CTA) test as a screening tool for diagnosis of cutaneous allodynia in patients with viscerally related chronic pelvic pain (CPP).
  
  
  METHODS
  We performed a prospective cohort comparative observational study of referred patients to a gynecology clinic with CPP. A total of 22 females with CPP were compared to 23 pain-free controls and 12 cyclic pain patients. Participants were evaluated by 2 clinicians. The CTA test was performed to detect the appearance of pain in dermatomes of T10-L1.
  
  
  RESULTS
  Interrater reliability resulted in 98% agreement for the 3 study groups. CTA test showed 73% sensitivity and 100% specificity for differentiating patients with CPP from pain-free patients.
  
  
  CONCLUSIONS
  The CTA test had excellent interrater reliability and concurrent validity for diagnosis of cutaneous allodynia in CPP patients with visceral diseases versus controls.
authors.affiliation: Department of Obstetrics and Gynecology, Foothills Medical Center, University of Calgary, Calgary, Alberta, Canada. Maryam.nasr-esfahani@albertahealthservices.ca
authors.forename: Maryam
authors.initials: M
authors.lastname: Nasr-Esfahani
authors.forename: John
authors.initials: J
authors.lastname: Jarrell
mesh_terms: D000328:Adult; D059350:Chronic Pain / Q000175:diagnosis*; D005260:Female; D006801:Humans; D006930:Hyperalgesia / Q000175:diagnosis*; D008875:Middle Aged; D017699:Pelvic Pain / Q000175:diagnosis*; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity