Validity of Brief Pain Inventory Questionnaire in Describing Trigeminal Neuralgia and
Temporomandibular Joint Disorder Patients
K Caroline Sunitha1* and Arvind Muthukrishnan2
1Consultant, Oral Medicine and Radiology, Hyderabad, India
2Professor, Department of Oral Medicine and Radiology, Saveetha Dental College and Hospital, Saveetha Institute of Medical and Technical Sciences, India
*Corresponding Author: K Caroline Sunitha, Consultant, Oral Medicine and Radiology, Hyderabad, India.
Received: October 25, 2021; Published: December 02, 2021
Background and Objectives: Multidimensional pain assessment plays an important role in evaluating diagnosis and treatment. The aim and objectives of the present study is to identify the descriptors for trigeminal neuralgia and temporomandibular joint disorder patients using the brief pain inventory questionnaire and to evaluate its validity and assess the discriminative capacity of the questionnaire in the same patients respectively.
Materials and Methods: Total sample of 144 patients was divided into two groups’ i.e., trigeminal neuralgia (72) and temporomandibular joint disorder (72). After obtaining ethical clearance and consent from pain patients with trigeminal neuralgia or temporomandibular joint disorder, using the Standard English version of brief pain inventory questionnaire, the patients were asked to select a descriptor which best describes their pain intensity and the pain severity and interference was graded. The attending oral physician interviewed and filled in the questionnaire based on the patient’s responses (clinician administered questionnaire). After completion of the questionnaire, the scores were analyzed and necessary treatments were given to all the patients.
Results: Patients in trigeminal neuralgia group chose “sharp, stabbing, shooting, burning, numb and unbearable” and in temporomandibular joint disorder group chose “aching, nagging” to describe their pain. Chi-square test was done to compare the proportions between these two pain groups p- value was significant (p < 0.001). Correlations between pain intensity and pain interference scores in both the study groups showed a positive value for Pearson’s coefficient (r) =0.614 and high statistical significance (p < 0.001). Factor analysis done with rotated component matrix and Varimax with Kaiser Normalization method to identify factor loadings for pain intensity and pain interference scores revealed two factors and the p-value was significant. Receiver operating curve analysis was done to find a best cut off value for activity score to categorize between trigeminal neuralgia and temporomandibular joint disorder and the area under the curve was 0.624 with a sensitivity, specificity, negative predictive value, positive predictive value, overall accuracy to be 45.8%, 76.4%, 58.5%, 66.0%, 61.1% respectively. For sleep score, the area under curve was 0.651 and the sensitivity, specificity, negative predictive value, positive predictive value and overall accuracy was 68.1%, 58.3%, 64.6%, 62%, and 63.2% respectively.
Conclusion: Though area under curve, sensitivity and specificity of BPI are not excellent, it has higher value than a random classifier. In conclusion, brief pain inventory use as a diagnostic tool alone can be improved by developing new questions and precision tests in further clinical studies.
Keywords: Pain, Trigeminal Neuralgia; Temporomandibular Joint Disorder; Brief Pain Inventory; Validity
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