Proposing a Scoring System for the Research Criteria of Complex Regional Pain Syndrome

ABSTRACT

This study evaluated the structure of complex regional pain syndrome (CRPS) population and suggested a weighted scoring system to balance on objective signs. One hundred sixty-eight consecutive patients were evaluated using the Budapest Research Criteria (BRC). By using multidimensional scaling and logistic regression analysis, we analyzed the degree of importance and relationships between objective findings. In addition, a receiver operating characteristic curve was constructed using a weighted score derived from the risk ratio as a diagnostic test. There were correlations between skin color change and edema, and between decreased range of motion and motor dysfunction when multidimensional scaling was applied. The trophic change was excluded by a logistic regression (95% CI; 0.80-11.850). The cutoff point based on weighted score derived from the risk ratios for determining CRPS was 7.88. At this point, the sensitivity, specificity, positive predictive value and negative predictive value were 75.0%, 95.3%, 96.3%, and 70.1%, respectively. We propose a weighted scoring system for the BRC using risk ratios of objective signs. Although a thorough systematic review would be required in the future, this study can contribute to reduction of the possible distortion of the feature of CRPS populations by the BRC.