Diagnostic Tools and Patient-Reported Outcome Measures: Convergent Approach between Clinical Setting and Research

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Point-of-Care Diagnostics and Devices".

Deadline for manuscript submissions: closed (11 November 2022) | Viewed by 6303

Special Issue Editors


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Guest Editor

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Guest Editor
Department of Social and Health Sciences, Radiology and Physical Medicine, Universidad de Cordoba, 14004 Córdoba, Spain
Interests: physical therapy; pelvic floor disorders; musculoskeletal pain

Special Issue Information

Dear Colleagues,

Historically, the evaluation of the patient in clinical settings has been supported by subjective and objective sources of information. Currently, the standardization of the procedures has subjected the assessment of the clinical status of the patient and its monitoring to the Evidence-Based paradigm. This is challenging, since many of the symptoms and signs that define different clinical entities are not always well described or even hard to obtain and interpret, such as in the case of some neurological, musculoskeletal or behavioral syndromes.

In recent years, significant research and technological efforts have been made to improve the clinimetric features of the assessment tools to achieve higher quality data extracted from clinical examination in many areas. Furthermore, convergent approaches between subjective and objective assessment tools have improved the definition of clinical entities (i.e.: diagnosis of myofascial syndromes, characterization of biomechanical alterations, neurological syndromes, among others).

In summary, this Special Issue targets any innovative evaluation tool that aims to improve the description and diagnosis of clinical entities in clinical settings and is accompanied by a combination of subjective and objective assessment tools.

 

Prof. Dr. Francisco Alburquerque-Sendín
Dr. Daiana Priscila Rodrigues-de-Souza
Guest Editors

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Keywords

  • Innovative diagnostic tools
  • Patient-Reported Outcome Measures
  • Clinical setting
  • Clinimetric features

Published Papers (3 papers)

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Research

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12 pages, 15586 KiB  
Article
Reliability of Ulnar Nerve Sensation Tests in Patients with Cubital Tunnel Syndrome and Healthy Subjects
by Tomasz Wolny, César Fernández-de-las Peñas, Arkadiusz Granek and Paweł Linek
Diagnostics 2022, 12(10), 2347; https://doi.org/10.3390/diagnostics12102347 - 28 Sep 2022
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Abstract
Static two-point discrimination (2PD) and Semmes–Weinstein monofilament (SWM) tests are commonly used to evaluate sensory disorders in the hand. The aim of this study was to evaluate the reliability of 2PD and SWM tests in the ulnar nerve innervation area in patients with [...] Read more.
Static two-point discrimination (2PD) and Semmes–Weinstein monofilament (SWM) tests are commonly used to evaluate sensory disorders in the hand. The aim of this study was to evaluate the reliability of 2PD and SWM tests in the ulnar nerve innervation area in patients with cubital tunnel syndrome (CuTS) and healthy individuals. This was a two-group repeated-measures inter-rater and intra-rater reliability study. Twenty-one patients with CuTS and 30 healthy adults participated. The static 2PD test was performed using a standardized Dellon discriminator, whereas the SWM test was conducted using TOUCH TEST monofilaments. Two examiners performed both tests at the hypothenar eminence and the fourth and fifth digits (ulnar nerve innervation hand territory). First, examiner A conducted three series of 2PD and SWM tests twice with a 15-min rest period (within-day intra-rater reliability). Next, examiner B repeated the same examination 5 min after (inter-rater reliability). Examiner A conducted the same examination 7 days after (between-day intra-rater reliability). For single measurements, the inter-rater reliability and within-day intra-rater reliability in the 2PD was at least 0.81 in patients with CuTS or healthy subjects. The between-days intra-rater reliability for a single measurement varied from 0.56 to 0.95 in CuTS patients and healthy subjects. The between-days intra-rater reliability for mean value from three measurements was above 0.80. The kappa for SWM was above 0.8 and the percentage of agreement was at least 90% for all sessions and trials. In conclusion, the 2PD and SWM tests are reliable for assessing sensation in the ulnar nerve innervation area of the hand in patients with CuTS and healthy subjects. Full article
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10 pages, 730 KiB  
Article
Validity of the Isometric Contraction Test of the Masticatory Muscles for Diagnosis of Muscular Temporomandibular Disorders
by Marcos Iglesias-Peón, Juan Mesa-Jiménez, César Fernández-de-las-Peñas, Jorge Rojas-García, Daiana Priscila Rodrigues-de-Souza and Francisco Alburquerque-Sendín
Diagnostics 2022, 12(8), 1861; https://doi.org/10.3390/diagnostics12081861 - 1 Aug 2022
Cited by 1 | Viewed by 1649
Abstract
In recent years, the Diagnostic Criteria for Temporomandibular Pain Disorders (DC/TMD) has been questioned, mainly because of the dependence on the muscular pressure needed to be applied during the clinical examination. Therefore, it is necessary to establish improvements in diagnostic strategies for DC/TMD [...] Read more.
In recent years, the Diagnostic Criteria for Temporomandibular Pain Disorders (DC/TMD) has been questioned, mainly because of the dependence on the muscular pressure needed to be applied during the clinical examination. Therefore, it is necessary to establish improvements in diagnostic strategies for DC/TMD of axis I. The aim of this study was to determine the validity of the Isometric Contraction Test of the masticatory muscles (ICTest) to diagnose DC/TMD of axis I. Forty (n = 40) patients with muscular TMD (myalgia in any of its subtypes), as well as forty age and sex matched controls, participated. They were diagnosed according to DC/TMD of axis I and performed the ICTest in a single session. Sensitivity, specificity, positive (PPV) and negative predictive values (NPV), and positive (LR+) and negative likelihood ratios (LR−) of the ICTest compared with the DC/TMD of axis I were calculated. The ICTest showed a specificity of 95% for the diagnosis of myalgia, and between 94.9% and 96.8% for all subtypes in relation to the DC/TMD of axis I. For sensitivity, lower values were obtained, that is, 90.0% for myalgia, and losing sensitivity depending on the type of myalgia. The LR+ was over 10 for all diagnoses, with the exception of myofascial pain with referral, which was lower. When addressing the LR−, the myofascial diagnosis was the only one below 0.2. According to the results, the ICTest could be considered a valid procedure to diagnose subjects with muscular TMD in a clinical setting. Full article
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Review

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16 pages, 1825 KiB  
Review
Clinical Assessment of Chronic Musculoskeletal Pain—A Framework Proposal Based on a Narrative Review of the Literature
by Helen Cristina Nogueira Carrer, Gisele Garcia Zanca and Melina Nevoeiro Haik
Diagnostics 2023, 13(1), 62; https://doi.org/10.3390/diagnostics13010062 - 26 Dec 2022
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Abstract
The assessment of chronic musculoskeletal pain (CMP) is a challenge shared by several health professionals. Fragmented or incomplete assessment can cause deleterious consequences for the patient’s function. The objective of this paper was to propose a framework for clinical assessment of CMP based [...] Read more.
The assessment of chronic musculoskeletal pain (CMP) is a challenge shared by several health professionals. Fragmented or incomplete assessment can cause deleterious consequences for the patient’s function. The objective of this paper was to propose a framework for clinical assessment of CMP based on the current literature and following the conceptual model of the International Classification of Functioning and Health (ICF). We propose that the ICF rationale may help to guide the processes, acting as a moderator of the clinical assessment, since it changes the perspective used to obtain and interpret findings during anamnesis and physical examination. Additionally, updated specific knowledge about pain, including that of pain domains and mechanisms, along with effective patient–clinician communication may act as a mediator of CMP assessment. We conduct the readers through the steps of the clinical assessment of CMP using both the proposed moderator and mediators and present a clinical example of application. We suggest that the proposed framework may help clinicians to implement a CMP assessment based on the biopsychosocial model using a critical and updated rationale, potentially improving assessment outcomes, i.e., clinical diagnosis. Full article
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