Dataset Information

Somatosensory Testing in Pediatric Patients with Chronic Pain: An Exploration of Clinical Utility.

ABSTRACT: We aimed to evaluate the utility of clinical somatosensory testing (SST), an office adaptation of laboratory quantitative sensory testing, in a biopsychosocial assessment of a pediatric chronic somatic pain sample (N = 98, 65 females, 7-18 years). Stimulus-response tests were applied at pain regions and intra-subject control sites to cutaneous stimuli (simple and dynamic touch, punctate pressure and cool) and deep pressure stimuli (using a handheld pressure algometer, and, in a subset, manually inflated cuff). Validated psychological, pain-related and functional measures were administered. Cutaneous allodynia, usually regional, was elicited by at least one stimulus in 81% of cases, most frequently by punctate pressure. Central sensitization, using a composite measure of deep pressure pain threshold and temporal summation of pain, was implied in the majority (59.2%) and associated with worse sleep impairment and psychological functioning. In regression analyses, depressive symptoms were the only significant predictor of pain intensity. Functional interference was statistically predicted by deep pressure pain threshold and depressive symptoms. Manually inflated cuff algometry had comparable sensitivity to handheld pressure algometry for deep pressure pain threshold but not temporal summation of pain. SST complemented standard biopsychosocial assessment of pediatric chronic pain; use of SST may facilitate the understanding of disordered neurobiology.

SUBMITTER: Kersch A

PROVIDER: S-EPMC7762158 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature

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Somatosensory Testing in Pediatric Patients with Chronic Pain: An Exploration of Clinical Utility.

Kersch Anna A Perera Panchalee P Mercado Melanie M Gorrie Andrew A Sainsbury David D McGrath Tara T Aouad Phillip P Sarraf Sara S Jaaniste Tiina T Champion David D

Children (Basel, Switzerland) 20201205 12

We aimed to evaluate the utility of clinical somatosensory testing (SST), an office adaptation of laboratory quantitative sensory testing, in a biopsychosocial assessment of a pediatric chronic somatic pain sample (N = 98, 65 females, 7-18 years). Stimulus-response tests were applied at pain regions and intra-subject control sites to cutaneous stimuli (simple and dynamic touch, punctate pressure and cool) and deep pressure stimuli (using a handheld pressure algometer, and, in a subset, manually ...[more]

PMID: 33291481

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Project description:Rationale & objectiveThe identification of pathogenic variants in genes associated with chronic kidney disease can provide patients and nephrologists with actionable information to guide diagnoses and therapeutic plans. However, many nephrologists do not use genetic testing despite costs decreasing over time and more widespread availability.Study designWe conducted a survey to uncover the perceptions of general adult nephrologists about the utility of and barriers to genetic testing in clinical practice.Setting & participantsThe online survey was administered to board-certified nephrologists (n = 10,054) in the United States.Analytical approachWe analyzed demographic characteristics of the survey respondents and their responses in the context of their use of genetic testing in routine clinical practice.ResultsA total of 149 nephrologists completed the survey, with 72% (107 of 149) reporting genetic test use in their practice. On average, tests were ordered for 3.8% of their patient population. Thirty-five percent of responses from nephrologists without a history of genetic test use ranked perceived barriers as "extremely significant" compared with 23% of responses from those who had previously used genetic tests. However, both users and nonusers of genetic tests indicated high cost (users: 46%, 49 of 107; nonusers 69%, 29 of 42) and poor availability or lack of ease (users: 33%, 35 of 107; nonusers: 57%; 24 of 42) of genetic testing as the most significant perceived barriers to implementation.LimitationsThe survey used in this study was not previously validated; additionally, because of the relatively small number of responses, there might have been a selection bias among the responders.ConclusionsAlthough most nephrologists reported using genetic tests in clinical practice, high costs and poor availability or the lack of ease of use were perceived as the most important barriers to routine adoption. These observations indicate that educational programs that cover a range of topics, from genetics of chronic kidney disease to selection of the test, may help mitigate these barriers and enhance the use of genetic testing in nephrology practice.

Dataset Information

Somatosensory Testing in Pediatric Patients with Chronic Pain: An Exploration of Clinical Utility.

Publications

Somatosensory Testing in Pediatric Patients with Chronic Pain: An Exploration of Clinical Utility.

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