IASP taxonomy of chronic pain syndromes: preliminary assessment of reliability ¦ ⸢23.04⸥
IASP taxonomy of chronic pain syndromes: preliminary assessment of reliability ¦ ⸢23.04⸥
IASP Taxonomy of Chronic Pain Syndromes: Preliminary Assessment of Reliability
Introduction
The absence of a standardized classification system for chronic pain syndromes has hindered the advancement of knowledge and treatment in this field. The IASP Subcommittee on Taxonomy proposed a multiaxial classification system consisting of 5 axes to address this issue. This study focuses on evaluating the interjudge reliability of two of these axes: body location and presumed etiology. The findings suggest areas for potential improvement in the clinical utility of the taxonomy.
Methodology for Establishing Interrater Reliability
Reliability assessment of the IASP classification system involves unique statistical methodologies based on nominal and ordinal measurement scales. The kappa statistic is utilized to measure agreement between raters, correcting for chance agreement. The study examines the reliability of axes based on clinical judgment rather than patient reports, aiming to establish a foundation for future research and refinement of the taxonomy.
Results of the Study
Interrater agreement on the primary site of pain (axis I) was found to be high, with physicians showing a 93.3% agreement rate. The kappa coefficient for this axis was 0.89, indicating substantial agreement. However, the reliability of presumed etiology (axis V) was found to be fair, suggesting room for improvement. The study also highlights the challenges in assessing reliability of certain axes due to insufficient variability in patient diagnoses.
