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Phenotyping Chronic Pelvic Pain Based on Latent Class Modeling of Physical Examination
Introduction. Defining clinical phenotypes based on physical examination is required for clarifying heterogeneous disorders such as chronic pelvic pain (CPP). The objective of this study was to determine the number of classes within 4 examinable regions and then establish threshold and optimal exam...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Hindawi Publishing Corporation
2013
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3885108/ https://www.ncbi.nlm.nih.gov/pubmed/24455240 http://dx.doi.org/10.1155/2013/891301 |
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author | Fenton, B. W. Grey, S. F. Reichenbach, M. McCarroll, M. Von Gruenigen, V. |
author_facet | Fenton, B. W. Grey, S. F. Reichenbach, M. McCarroll, M. Von Gruenigen, V. |
author_sort | Fenton, B. W. |
collection | PubMed |
description | Introduction. Defining clinical phenotypes based on physical examination is required for clarifying heterogeneous disorders such as chronic pelvic pain (CPP). The objective of this study was to determine the number of classes within 4 examinable regions and then establish threshold and optimal exam criteria for the classes discovered. Methods. A total of 476 patients meeting the criteria for CPP were examined using pain pressure threshold (PPT) algometry and standardized numeric scale (NRS) pain ratings at 30 distinct sites over 4 pelvic regions. Exploratory factor analysis, latent profile analysis, and ROC curves were then used to identify classes, optimal examination points, and threshold scores. Results. Latent profile analysis produced two classes for each region: high and low pain groups. The optimal examination sites (and high pain minimum thresholds) were for the abdominal wall region: the pair at the midabdomen (PPT threshold depression of > 2); vulvar vestibule region: 10:00 position (NRS > 2); pelvic floor region: puborectalis (combined NRS > 6); vaginal apex region: uterosacral ligaments (combined NRS > 8). Conclusion. Physical examination scores of patients with CPP are best categorized into two classes: high pain and low pain. Standardization of the physical examination in CPP provides both researchers and general gynecologists with a validated technique. |
format | Online Article Text |
id | pubmed-3885108 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | Hindawi Publishing Corporation |
record_format | MEDLINE/PubMed |
spelling | pubmed-38851082014-01-21 Phenotyping Chronic Pelvic Pain Based on Latent Class Modeling of Physical Examination Fenton, B. W. Grey, S. F. Reichenbach, M. McCarroll, M. Von Gruenigen, V. Pain Res Treat Clinical Study Introduction. Defining clinical phenotypes based on physical examination is required for clarifying heterogeneous disorders such as chronic pelvic pain (CPP). The objective of this study was to determine the number of classes within 4 examinable regions and then establish threshold and optimal exam criteria for the classes discovered. Methods. A total of 476 patients meeting the criteria for CPP were examined using pain pressure threshold (PPT) algometry and standardized numeric scale (NRS) pain ratings at 30 distinct sites over 4 pelvic regions. Exploratory factor analysis, latent profile analysis, and ROC curves were then used to identify classes, optimal examination points, and threshold scores. Results. Latent profile analysis produced two classes for each region: high and low pain groups. The optimal examination sites (and high pain minimum thresholds) were for the abdominal wall region: the pair at the midabdomen (PPT threshold depression of > 2); vulvar vestibule region: 10:00 position (NRS > 2); pelvic floor region: puborectalis (combined NRS > 6); vaginal apex region: uterosacral ligaments (combined NRS > 8). Conclusion. Physical examination scores of patients with CPP are best categorized into two classes: high pain and low pain. Standardization of the physical examination in CPP provides both researchers and general gynecologists with a validated technique. Hindawi Publishing Corporation 2013 2013-12-22 /pmc/articles/PMC3885108/ /pubmed/24455240 http://dx.doi.org/10.1155/2013/891301 Text en Copyright © 2013 B. W. Fenton et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Clinical Study Fenton, B. W. Grey, S. F. Reichenbach, M. McCarroll, M. Von Gruenigen, V. Phenotyping Chronic Pelvic Pain Based on Latent Class Modeling of Physical Examination |
title | Phenotyping Chronic Pelvic Pain Based on Latent Class Modeling of Physical Examination |
title_full | Phenotyping Chronic Pelvic Pain Based on Latent Class Modeling of Physical Examination |
title_fullStr | Phenotyping Chronic Pelvic Pain Based on Latent Class Modeling of Physical Examination |
title_full_unstemmed | Phenotyping Chronic Pelvic Pain Based on Latent Class Modeling of Physical Examination |
title_short | Phenotyping Chronic Pelvic Pain Based on Latent Class Modeling of Physical Examination |
title_sort | phenotyping chronic pelvic pain based on latent class modeling of physical examination |
topic | Clinical Study |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3885108/ https://www.ncbi.nlm.nih.gov/pubmed/24455240 http://dx.doi.org/10.1155/2013/891301 |
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