Outcome Measures

in Neuropathic Pain

Suroto / Yudiyanta
Dept of Neurology, Fac of Medicine
Sebelas Maret University
www.suroto-sr.com
Outcomes Measurement

 Outcomes measurement: systematic collection and analysis

of information - evaluate the efficacy of an intervention.

 In clinical settings: collected before and after an

intervention.

 The best methode: psychometric scales and quality of life

measures.

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The ideal pain assessment tool
would have the following attributes
1. Sensitive and free from bias
2. Immediate information about accuracy and
reliability
3. Distinguishes between pain, unpleasantness and
emotion;
4. Assesses experimental and clinical pain;
5. Absolute rather than relative scales;
6. Estimates confidence of predictions.

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1. Pain and Pain Measurement
2. Detecting Neuropathic Pain Component
3. Neuropathic Pain and Outcome Measurement

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 Unidimensional vs Multidimensional Scale

• In many situations, one-item instrument is not sufficient to

capture pain or quality of life.
• Measure several dimensions of pain :
• Pain intensity and quality,
• Affect, interference with functioning,
• Effects on general quality of life.

• By comprehensive measure of pain  managing the lack of

association between pain intensity and disability.

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 Pain Assessment Scales

Uni-Dimensional Scale Multi-Dimensional Scale

• Only measures pain intensity • Both intensity (severity) and

• Appropriate for acute pain
• The most common scale used in
outcome assessment (Analgesic
efficacy)
unpleasantness (affective)
• Appropriate for chronic pain
• Research /pathophysiology
• Should be used in clinical
outcome assessment

Verbal Rating Scale (VRS)

McGill Pain Questionnaire (MPQ)
None, mild, moderate, severe
The Brief Pain Inventory (BPI)
Numeric Rating Scale (NRS)
The Memorial Pain Assessment Card
Visual Analog Scale (VAS)
Pictorial Scale
Unidimensional Scale

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1. Pain and Pain Measurement
2. Detecting Neuropathic Pain Component
3. Neuropathic Pain and Outcome Measurement

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Flow chart of grading system for neuropathic pain

PAIN (2010), doi:10.1016 10

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1. Pain and Pain Measurement
2. Detecting Neuropathic Pain Component
3. Neuropathic Pain and Outcome Measurement

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Outcome Measuring tool of NP

• NPS: Neuropathic Pain Scale

• NPSI: Neuropathic Pain Symptom Inventory

• PQAS: Pain Quality Assessment Scale

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 Outcome Measuring tool of NP

• Only for use in patients who have already been diagnosed with
NP.
• Scores are based on patient responses to questions about pain
intensity: 0 indicates no pain; 10 indicates the most pain
imaginable.
• Comprehensive and wise method for assessing NP and may be
particularly useful for assessing response to therapies.

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 NPS: Neuropathic Pain Scale
Sensory profile and its impact on quality of life in patients
with painful diabetic polyneuropathy.

J Neurosci Rural Pract. 2013 Jul-Sep; 4(3): 267–270.

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The Pain Quality Assessment Scale (PQAS) in Carpal Tunnel Syndrome

22823-83
The Journal of Pain, Vol 7, No 11 (November), 2006: pp
Summary
 Outcomes measurement: systematic collection and analysis of
information - evaluate the efficacy of an intervention
 In many situations, one-item instrument is not sufficient to capture
pain or quality of life.
 Some scales used to determine IF a patient's pain is secondary to
neuropathy: NPQ, ID- pain, painDetect, LANSS, DN4.
 The Neuropathic Pain Scale (NPS) has the most empirical support
as a measure of treatment outcome in NP. Also Pain Quality
Assessment Scale (PQAS)

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