Contribution of Individual Items to the Performance of the Norton Pressure Ulcer Prediction Scale

Perneger, Thomas; Gaspoz, Jean‐Michel; Raë, Anne-Claire; Borst, F.; Heliot, Céliane

doi:10.1111/j.1532-5415.1998.tb04547.x

Cited by 25 publications

(28 citation statements)

References 13 publications

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“…Another potential limitation is that our analyses were exploratory and no formal correction was applied for multiple testing. However, it should be noted that lowering the significance threshold and thus decreasing the risk of type I error by such correction methods also leads to a large increase of the likelihood of type II errors [22]. We aimed to avoid the risk of false-negative results and, despite lack of correction, consider our findings of importance to generate new working hypotheses and to adequately power future studies related to this topic.…”

Section: Discussionmentioning

confidence: 96%

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Neuropathic pain phenotyping as a predictor of treatment response in painful diabetic neuropathy: Data from the randomized, double-blind, COMBO-DN study

Bouhassira

Wilhelm

Schacht³

et al. 2014

Pain

118

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Sensory profiles are heterogeneous in neuropathic pain disorders, and subgroups of patients respond differently to treatment. To further explore this, patients in the COMBO-DN study were prospectively assessed by the Neuropathic Pain Symptom Inventory (NPSI) at baseline, after initial 8-week therapy with either duloxetine or pregabalin, and after subsequent 8-week combination/high-dose therapy. Exploratory post hoc cluster analyses were performed to identify and characterize potential subgroups through their scores in the NPSI items. In patients not responding to initial 60 mg/d duloxetine, adding 300 mg/d pregabalin for combination treatment was particularly effective regarding the dimensions pressing pain and evoked pain, whereas maximizing the duloxetine dose to 120 mg/d appeared more beneficial regarding paresthesia/dysesthesia. In contrast, adding 60 mg/d duloxetine to 300 mg/d pregabalin in case of nonresponse to initial pregabalin led to numerically higher decreases in all NPSI dimensions/items compared to maximizing the pregabalin dose to 600 mg/d. Cluster analysis revealed 3 patient clusters (defined by baseline scores for the 10 NPSI sensory items) with different pain profiles, not only in terms of overall pain severity, but also across NPSI items. Mean Brief Pain Inventory average pain improved in all clusters during combination/high-dose therapy. However, in patients with severe pain, the treatment effect showed a trend in favor of high-dose monotherapy, whereas combination therapy appeared to be more beneficial in patients with moderate and mild pain (not significant). These complementary exploratory analyses further endorse the idea that sensory phenotyping might lead to a more stratified treatment and potentially to personalized pain therapy.

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Section: Discussionmentioning

confidence: 96%

“…Evidence suggests that in painful diabetic neuropathy, only a few drugs achieve greater than 30% reduction in pain in more than 50% of patients [21,22,26,28]. Combination therapy has been pursued to optimize clinical outcomes [16].…”

Section: Introductionmentioning

confidence: 99%

Neuropathic pain phenotyping as a predictor of treatment response in painful diabetic neuropathy: Data from the randomized, double-blind, COMBO-DN study

Bouhassira

Wilhelm

Schacht³

et al. 2014

Pain

118

View full text Add to dashboard Cite

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“…This deficiency in performance may be attributable to multiple factors. 33,50,51 In daily practice, they could be evaluated within general nursing assessments with instruments such as the CDS. 48 Multiple factors are associated with the formation of pressure ulcers, and many are closely related, rendering it difficult to determine the magnitude of their contribution to overall risk.…”

Section: ■ Discussionmentioning

confidence: 99%

The Norton, Waterlow, Braden, and Care Dependency ScalesL Comparing Their Validity When Identifying Patients' Pressure Sore Risk

Balzer

Pohl

Dassen

et al. 2007

Journal of Wound, Ostomy &Amp; Continence Nursing

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“…In previous studies the professional skills of the researchers have affected the reliability of the risk assessment scales because risk factors were not tested statistically but developed through clinical experience. Recently, the Norton and Braden scales have been studied extensively, particularly the scales' predictive value, sensitivity, and specificity 36–42 …”

Section: Review Of the Literaturementioning

confidence: 99%

Patients with pressure ulcers in Finnish hospitals

Lepistö

Eriksson

Hietanen

et al. 2001

Int J of Nursing Practice

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The purpose of this descriptive study was to produce knowledge of the degree of pressure ulcers, pressure ulcer patients' physical and psychological well-being and the association of these factors with pressure ulcers' severity. These patients were treated in Finland's capital area hospitals. The pressure ulcer patients' sampling was gathered during 1 day with two questionnaires, which was completed by nurses. The response rate was 94%, and data analysis was based on percentage distributions. Statistical association was tested with the chi2 test. The measurement identified 164 patients with a total of 257 pressure ulcers. Prevalence was 6.4%. Most of the ulcers (40%) were grade II ulcers. Fifty-six per cent of patients suffered poor general health, 63% of the patients were immobile, but psychological well-being was better with 29% of pressure ulcer patients being adequately motivated to follow treatment for their pressure ulcers. It is essential to identify high-risk patients in order to provide optimal care.

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Contribution of Individual Items to the Performance of the Norton Pressure Ulcer Prediction Scale

Abstract: Our study suggests that the activity and mobility items of the Norton scale are sufficient to express the risk of pressure ulcers in hospitalized patients. Confirmation of this finding in prospective studies is warranted.

Cited by 25 publications

References 13 publications

Neuropathic pain phenotyping as a predictor of treatment response in painful diabetic neuropathy: Data from the randomized, double-blind, COMBO-DN study

Neuropathic pain phenotyping as a predictor of treatment response in painful diabetic neuropathy: Data from the randomized, double-blind, COMBO-DN study

The Norton, Waterlow, Braden, and Care Dependency ScalesL Comparing Their Validity When Identifying Patients' Pressure Sore Risk

Patients with pressure ulcers in Finnish hospitals

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