title: Neuropathic pain and use of PainDETECT in patients with fibromyalgia: a cohort study.
abstract: BACKGROUND
  Fibromyalgia has a plethorae of symptoms, which can be confusing and even misleading. Accurate evaluation is necessary when patients with fibromyalgia are treated. Different types of instruments are available for the clinicians to supplement evaluation. Our objective was to study the applicability of the PainDETECT instrument to screen neuropathic pain in patients with fibromyalgia.
  
  
  METHODS
  158 patients with primary fibromyalgia underwent a neurological examination including bedside sensory testing. They also fulfilled four questionnaires: PainDETECT, Beck depression inventory IA (BDI IA), Fibromyalgia Impact Questionnaire (FIQ) and a self-made questionnaire regarding present pain and pain relieving methods of the patients. The results of the clinical evaluation and questionnaires were then compared.
  
  
  RESULTS
  Clinically verified neuropathic pain was diagnosed in 53/158 [34% (95% Cl: 26 to 41)] patients. The ROC curve achieved a maximum Youden´s index at score of 17 when sensitivity was 0.79 (95% Cl: 0.66 to 0.89) and specificity 0.53 (95% Cl: 0.43 to 0.63). The PainDETECT total score (OR: 1.14 95% Cl: 1.06 to 1.22), FM as the worst current pain (OR: 0.31; 95% 0.16 to 0.62), body mass index (BMI) (OR: 1.05; 95% Cl: 1.00 to 1.11) and the intensity of current pain (OR: 1.20; 95% Cl: 1.01 to 1.41) were significantly associated with the presence of neuropathic pain in univariate analyses.
  
  
  CONCLUSIONS
  This study highlights the importance of thorough clinical examination. The Neuropathic pain screening tool PainDETECT is not as useful in patients with fibromyalgia as in patients with uncompromised central pain control.
authors: ORTON Rehabilitation Centre, ORTON Foundation, Helsinki, Finland. jarno.gauffin@orton.fi
authors: Jarno
authors: J
authors: Gauffin
authors: Tiina
authors: T
authors: Hankama
authors: Hannu
authors: H
authors: Kautiainen
authors: Pekka
authors: P
authors: Hannonen
authors: Maija
authors: M
authors: Haanpää
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D005356:Fibromyalgia / Q000150:complications*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009437:Neuralgia / Q000175:diagnosis* / Q000209:etiology*; D010147:Pain Measurement / Q000295:instrumentation* / Q000379:methods*; D012372:ROC Curve