Multifactorial assessment of measurement errors affecting intraoral quantitative sensory testing reliability

Multifactorial assessment of measurement errors affecting intraoral quantitative sensory testing... AbstractBackground and purpose (aims)Measurement error of intraoral quantitative sensory testing (QST) has been assessed using traditional methods for reliability, such as intraclass correlation coefficients (ICCs). Most studies reporting QST reliability focused on assessingone source of measurement error at a time, e.g., inter- or intra-examiner (test–retest) reliabilities and employed two examiners to test inter-examiner reliability. The present study used a complex design with multiple examiners with the aim of assessing the reliability of intraoral QST taking account of multiple sources of error simultaneously.MethodsFour examiners of varied experience assessed 12 healthy participants in two visits separated by 48 h. Seven QST procedures to determine sensory thresholds were used: cold detection (CDT), warmth detection (WDT), cold pain (CPT), heat pain (HPT), mechanical detection (MDT), mechanical pain (MPT) and pressure pain (PPT). Mixed linear models were used to estimate variance components for reliability assessment; dependability coefficients were used to simulate alternative test scenarios.ResultsMost intraoral QST variability arose from differences between participants (8.8–30.5%), differences between visits within participant (4.6–52.8%), and error (13.3–28.3%). For QST procedures other than CDT and MDT, increasing the number of visits with a single examiner performing the procedures would lead to improved dependability (dependability coefficient ranges: single visit, four examiners = 0.12–0.54; four visits, single examiner = 0.27–0.68). A wide range of reliabilities for QST procedures, as measured by ICCs, was noted for inter- (0.39–0.80) and intra-examiner (0.10–0.62) variation.ConclusionReliability of sensory testing can be better assessed by measuring multiple sources of error simultaneously instead of focusing on one source at a time. In experimental settings, large numbers of participants are needed to obtain accurate estimates of treatment effects based on QST measurements. This is different from clinical use, where variation between persons (the person main effect) is not a concern because clinical measurements are done on a single person.ImplicationsFuture studies assessing sensorytestingreliabilityinboth clinicaland experimental settings would benefit from routinely measuring multiple sources of error. The methods and results of this study can be used by clinical researchers to improve assessment of measurement error related to intraoral sensorytesting. This should lead to improved resource allocation when designing studies that use intraoral quantitative sensory testing in clinical and experimental settings.© 2017 Scandinavian Association for the Study of Pain. Published by Elsevier B.V. All rights reserved. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Scandinavian Journal of Pain de Gruyter

Multifactorial assessment of measurement errors affecting intraoral quantitative sensory testing reliability

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Publisher
de Gruyter
Copyright
© 2017 Scandinavian Association for the Study of Pain
ISSN
1877-8860
eISSN
1877-8879
D.O.I.
10.1016/j.sjpain.2017.03.007
Publisher site
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Abstract

AbstractBackground and purpose (aims)Measurement error of intraoral quantitative sensory testing (QST) has been assessed using traditional methods for reliability, such as intraclass correlation coefficients (ICCs). Most studies reporting QST reliability focused on assessingone source of measurement error at a time, e.g., inter- or intra-examiner (test–retest) reliabilities and employed two examiners to test inter-examiner reliability. The present study used a complex design with multiple examiners with the aim of assessing the reliability of intraoral QST taking account of multiple sources of error simultaneously.MethodsFour examiners of varied experience assessed 12 healthy participants in two visits separated by 48 h. Seven QST procedures to determine sensory thresholds were used: cold detection (CDT), warmth detection (WDT), cold pain (CPT), heat pain (HPT), mechanical detection (MDT), mechanical pain (MPT) and pressure pain (PPT). Mixed linear models were used to estimate variance components for reliability assessment; dependability coefficients were used to simulate alternative test scenarios.ResultsMost intraoral QST variability arose from differences between participants (8.8–30.5%), differences between visits within participant (4.6–52.8%), and error (13.3–28.3%). For QST procedures other than CDT and MDT, increasing the number of visits with a single examiner performing the procedures would lead to improved dependability (dependability coefficient ranges: single visit, four examiners = 0.12–0.54; four visits, single examiner = 0.27–0.68). A wide range of reliabilities for QST procedures, as measured by ICCs, was noted for inter- (0.39–0.80) and intra-examiner (0.10–0.62) variation.ConclusionReliability of sensory testing can be better assessed by measuring multiple sources of error simultaneously instead of focusing on one source at a time. In experimental settings, large numbers of participants are needed to obtain accurate estimates of treatment effects based on QST measurements. This is different from clinical use, where variation between persons (the person main effect) is not a concern because clinical measurements are done on a single person.ImplicationsFuture studies assessing sensorytestingreliabilityinboth clinicaland experimental settings would benefit from routinely measuring multiple sources of error. The methods and results of this study can be used by clinical researchers to improve assessment of measurement error related to intraoral sensorytesting. This should lead to improved resource allocation when designing studies that use intraoral quantitative sensory testing in clinical and experimental settings.© 2017 Scandinavian Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

Journal

Scandinavian Journal of Painde Gruyter

Published: Jul 1, 2017

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