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Reliability of Conditioned Pain Modulation: a Systematic Review.

Kennedy, DL; Kemp, HI; Ridout, D; Yarnitsky, D; Rice, AS; (2016) Reliability of Conditioned Pain Modulation: a Systematic Review. Pain , 157 (11) pp. 2410-2419. 10.1097/j.pain.0000000000000689. Green open access

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Abstract

A systematic literature review was undertaken to determine if conditioned pain modulation (CPM) is reliable. Longitudinal, English language observational studies of the repeatability of a CPM test paradigm in adult humans were included. Two independent reviewers assessed the risk of bias in six domains; study participation; study attrition; prognostic factor measurement; outcome measurement; confounding and analysis using the Quality in Prognosis Studies (QUIPS) critical assessment tool [17]. Intraclass correlation coefficients (ICCs) less than 0.4 were considered to be poor; 0.4 and 0.59 to be fair; 0.6 and 0.75 good and greater than 0.75 excellent [37]. Ten studies were included in the final review. Meta-analysis was not appropriate due to differences between studies. The intersession reliability of the CPM effect was investigated in 8 studies and reported as good (ICC = 0.6-.75) in 3 studies and excellent (ICC > .75) in subgroups in 2 of those 3. The assessment of risk of bias demonstrated that reporting is not comprehensive for the description of sample demographics, recruitment strategy and study attrition. The absence of blinding, a lack of control for confounding factors and lack of standardisation in statistical analysis are common. CPM is a reliable measure, however the degree of reliability is heavily dependent upon stimulation parameters and study methodology and this warrants consideration for investigators. The validation of CPM as a robust prognostic factor in experimental and clinical pain studies may be facilitated by improvements in the reporting of CPM reliability studies.

Type: Article
Title: Reliability of Conditioned Pain Modulation: a Systematic Review.
Open access status: An open access version is available from UCL Discovery
DOI: 10.1097/j.pain.0000000000000689
Publisher version: http://dx.doi.org/10.1097/j.pain.0000000000000689
Language: English
Additional information: Copyright © 2016 Wolters Kluwer Health, Inc. This is the accepted manuscript version of this article published in Pain; the final published version of record can be found at http://dx.doi.org/10.1097/j.pain.0000000000000689.
Keywords: Conditioned pain modulation (CPM), Diffuse noxious inhibitory control (DNIC), Endogenous pain modulation, Reliability, Systematic review
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Population, Policy and Practice Dept
URI: https://discovery.ucl.ac.uk/id/eprint/1514902
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