Can the LANSS scale be used to classify pain in chronic cancer pain trials?

Hardy, J; Quinn, S; Fazekas, B; Agar, M; Currow, D

Can the LANSS scale be used to classify pain in chronic cancer pain trials?

Hardy, J Quinn, S Fazekas, B Agar, M

Currow, D

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Publication Type:: Journal Article
Citation:: Supportive Care in Cancer, 2013, 21 (12), pp. 3387 - 3391
Issue Date:: 2013-12-01

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Field	Value	Language
dc.contributor.author	Hardy, J	en_US
dc.contributor.author	Quinn, S	en_US
dc.contributor.author	Fazekas, B	en_US
dc.contributor.author	Agar, M https://orcid.org/0000-0002-6756-6119	en_US
dc.contributor.author	Currow, D https://orcid.org/0000-0003-1988-1250	en_US
dc.date.available	2013-07-22	en_US
dc.date.issued	2013-12-01	en_US
dc.identifier.citation	Supportive Care in Cancer, 2013, 21 (12), pp. 3387 - 3391	en_US
dc.identifier.issn	0941-4355	en_US
dc.identifier.uri	http://hdl.handle.net/10453/115779
dc.description.abstract	Purpose: The Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) scale was developed to differentiate pain of predominantly neuropathic or nociceptive origin. The aim of this study was to determine whether the LANSS scale was an appropriate tool to classify pain in a trial of patients with advanced cancer and chronic refractory pain. Methods: Clinician assessment of pain type (neuropathic or nociceptive) was used to determine the sensitivity and specificity of LANSS scores in 112 trial participants. Those classified as "mixed" or of uncertain aetiology were excluded. We undertook several analyses in an attempt to improve the LANSS scale and better diagnose pain type for our specific dataset. Results: There was strong association between the LANSS score and a diagnosis of neuropathic versus nociceptive pain, p < 0.001. When the clinical assessment was compared with the LANSS scale, the overall accuracy was 94 % (79/84). The 5 false negatives and no false positives resulted in a sensitivity of 0.86 (0.70, 0.95), specificity of 1 (0.93, 1), positive predictive value of 1 (0.88, 1) and negative predictive value of 0.91 (0.80, 0.97). The negative likelihood ratio was 0.14 (0, 0.32). The scale had good discriminant and construct validity. Reliability was assessed via internal consistency with Cronbach's α = 0.76, similar to that of the original validation study (α = 0.74). None of the new scales developed was better at differentiating pain type. Conclusions: The LANSS scale predicted well for pain type in a cancer population and is a useful tool for classifying pain in cancer pain trials. © 2013 Springer-Verlag Berlin Heidelberg.	en_US
dc.relation.ispartof	Supportive Care in Cancer	en_US
dc.relation.isbasedon	10.1007/s00520-013-1921-5	en_US
dc.subject.classification	Oncology & Carcinogenesis	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Neoplasms	en_US
dc.subject.mesh	Neuralgia	en_US
dc.subject.mesh	Peripheral Nervous System Diseases	en_US
dc.subject.mesh	Ketamine	en_US
dc.subject.mesh	Analgesics	en_US
dc.subject.mesh	Pain Measurement	en_US
dc.subject.mesh	Sensitivity and Specificity	en_US
dc.subject.mesh	Reproducibility of Results	en_US
dc.subject.mesh	Aged	en_US
dc.subject.mesh	Middle Aged	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Male	en_US
dc.subject.mesh	Randomized Controlled Trials as Topic	en_US
dc.subject.mesh	Self-Assessment	en_US
dc.subject.mesh	Nociceptive Pain	en_US
dc.title	Can the LANSS scale be used to classify pain in chronic cancer pain trials?	en_US
dc.type	Journal Article
utslib.citation.volume	12	en_US
utslib.citation.volume	21	en_US
utslib.for	1112 Oncology and Carcinogenesis	en_US
utslib.for	11 Medical and Health Sciences	en_US
utslib.for	17 Psychology and Cognitive Sciences	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/IMPACCT
utslib.copyright.status	closed_access
pubs.issue	12	en_US
pubs.publication-status	Published	en_US
pubs.volume	21	en_US

Abstract:

Purpose: The Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) scale was developed to differentiate pain of predominantly neuropathic or nociceptive origin. The aim of this study was to determine whether the LANSS scale was an appropriate tool to classify pain in a trial of patients with advanced cancer and chronic refractory pain. Methods: Clinician assessment of pain type (neuropathic or nociceptive) was used to determine the sensitivity and specificity of LANSS scores in 112 trial participants. Those classified as "mixed" or of uncertain aetiology were excluded. We undertook several analyses in an attempt to improve the LANSS scale and better diagnose pain type for our specific dataset. Results: There was strong association between the LANSS score and a diagnosis of neuropathic versus nociceptive pain, p < 0.001. When the clinical assessment was compared with the LANSS scale, the overall accuracy was 94 % (79/84). The 5 false negatives and no false positives resulted in a sensitivity of 0.86 (0.70, 0.95), specificity of 1 (0.93, 1), positive predictive value of 1 (0.88, 1) and negative predictive value of 0.91 (0.80, 0.97). The negative likelihood ratio was 0.14 (0, 0.32). The scale had good discriminant and construct validity. Reliability was assessed via internal consistency with Cronbach's α = 0.76, similar to that of the original validation study (α = 0.74). None of the new scales developed was better at differentiating pain type. Conclusions: The LANSS scale predicted well for pain type in a cancer population and is a useful tool for classifying pain in cancer pain trials. © 2013 Springer-Verlag Berlin Heidelberg.

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http://hdl.handle.net/10453/115779