Patient reported outcome measures in trigeminal neuralgia – A systematic review of psychometric performance

Nova, Carolina Venda; Zakrzewska, Joanna M; Baker, Sarah R.; Ríordáin, Rícheal Ní

doi:10.1002/ejp.1779

Cited by 13 publications

(7 citation statements)

References 39 publications

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“…Another problem in evaluating the outcome after a surgical procedure for TN is the lack of consideration of the psychological aspects. A systematic review by Nova et al [ 40 ] stated that there was limited evidence of the psychometric performance of patient-reported outcomes for TN. Sandhu et al [ 41 ] reported on the minimum clinically important difference (MCID) interfering with activities of daily life (ADL) in facial pain using the Brief Pain Inventory Score (BPI).…”

Section: Discussionmentioning

confidence: 99%

Outcome Comparison of Drug-Resistant Trigeminal Neuralgia Surgical Treatments—An Umbrella Review of Meta-Analyses and Systematic Reviews

et al. 2023

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Medical treatment for trigeminal neuralgia (TN) is not always a feasible option due to a lack of full response or adverse effects. Open surgery or percutaneous procedures are advocated in these cases. Several articles have compared the results among different techniques. Nevertheless, the findings of these studies are heterogeneous. Umbrella reviews are studies sitting at the peak of the evidence pyramid. With this umbrella review, we provided a systematic review of the outcomes of the surgical procedures used for TN treatment. Only systematic reviews and meta-analyses were included following the PRISMA guidelines. Ten articles were enrolled for qualitative and quantitative assessment. Level of evidence was quantified using a specific tool (AMSTAR-2). Results were heterogenous in terms of outcome and measurements. Microvascular decompression (MVD) appeared to be the most effective procedure both in the short-term (pain relief in 85–96.6% of cases) and long-term follow-up (pain relief in 64–79% of cases), although showed the highest rate of complications. The results of percutaneous techniques were similar but radiosurgery showed the highest variation in term of pain relief and a higher rate of delayed responses. The use of the AMSTAR-2 tool to quantify the evidence level scored three studies as critically low and seven studies as low-level, revealing a lack of good quality studies on this topic. Our umbrella review evidenced the need of well-designed comparative studies and the utilization of validated scales in order to provide more homogenous data for pooled-analyses and meta-analyses in the field of TN surgical treatment.

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Section: Discussionmentioning

confidence: 99%

Outcome Comparison of Drug-Resistant Trigeminal Neuralgia Surgical Treatments—An Umbrella Review of Meta-Analyses and Systematic Reviews

et al. 2023

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“…The study was divided into five stages—see Figure 1 for details. Consensus methods are described in the present paper (stages 3 and 4); stages 1 and 2 have been described separately (Venda Nova et al, 2020 ; Venda Nova et al, 2021 ).…”

Section: Methodsmentioning

confidence: 99%

An international Delphi survey and consensus meeting to define the core outcome set for trigeminal neuralgia clinical trials

Nova

Ríordáin

Baker

et al. 2022

European Journal of Pain

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Background: Trigeminal neuralgia (TN) is an excruciating unilateral facial pain, which negatively affects patient's quality of life. Historically, it has been difficult to compare treatment efficacy due to the lack of standardized outcomes. In addition, patients' perspective has seldomly been acknowledged. The aim of this study was to reach consensus on what outcomes of treatment are important to different TN stakeholders (patients, clinicians and researchers), to identify the TN Core Outcome Set (TRINCOS).Methods: A list of outcomes identified through a systematic review and focus group work was used to develop the survey questionnaire. A three-round Delphi was conducted. Participants were asked to score the outcomes on scale from 1 to 9 (1-3 not important;4-6 important but not critical;7-9 critical). Outcomes scored as critical by ≥70% and not important by <15% were retained, and those for which no consensus was reached were discussed at a consensus meeting. Results: Of the 70 participants who completed the Delphi, 26 were patients, 38 were clinicians and six were researchers. Of the 40 outcomes presented, 17 were scored as critical and no consensus was met for 23 outcomes. Agreement was reached during a consensus meeting on 10 outcomes across six domains (pain, side effects, social impact, quality of life, global improvement, and satisfaction with treatment). Conclusion: Implementation of TRINCOS in future clinical trials will improve homogeneity of studies' results, reduce the redundancy in the outcome assessment and effectively allow comparison of different treatments to better inform researchers, clinicians and most importantly patients, about the efficacy of the different treatments.Significance: Implementation of a 10-item core outcome set in trigeminal neuralgia will improve comparability between studies allowing patients to have faster access to better treatments.

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“…[3] TN patients have increased symptoms such as anxiety, depression, insomnia, affecting basic psychological, physical, social needs and activities of patients, and TN is even called suicide disease. [1,4] Microvascular decompression (MVD) is the first-line surgical therapy for medically refractory patients. Lars Bendtsen et al [3] reported that MVD had a good effect, and 62% to 89% of patients exhibited no pain at follow-up (3-11 years later), but Giorgio Cruccu hold different opinions, he reported about 50% of TN patients also have persistent pain in the same area in addition to the characteristic paroxysmal episodes.…”

Section: The Authors Have No Funding and Conflicts Of Interest To Dis...mentioning

confidence: 99%

“…Trigeminal neuralgia (TN) is a disturbing chronic pain condition on 1 side of the face. The International Classification of Headache Disorders and International Classification of Orofacial Pain defined TN as “a recurrent unilateral transient electroshock-like pain that has a sudden onset and termination, limited to the distribution of 1 or more divisions of the trigeminal nerve and triggered by harmless stimuli.” [1] Touching the face, talking, eating, or drinking can all cause fierce pain. The nature and severity of the pain maybe related to delayed diagnosis, fear of pain, side effects of medications, and lack of psychological support.…”

Section: Introductionmentioning

confidence: 99%

Treatment of postsurgical trigeminal neuralgia with Fu’s subcutaneous needling therapy resulted in prompt complete relief: Two case reports

Gao

Sun

et al. 2023

Medicine

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Rationale: Trigeminal neuralgia is a recurrent unilateral transient electroshock-like pain. Fu’s subcutaneous needling (FSN), used to treat the musculoskeletal problems, has not been reported in this field. Patient concerns: The pain extent of case 1 had no reduction after the previous microvascular decompression, the pain of case 2 relapsed 4 years after the microvascular decompression. Diagnoses: Postsurgical trigeminal neuralgia. Interventions: FSN therapy was applied on the muscles around the neck and face area, which the myofascial trigger points were palpated in these muscles. The FSN needle was inserted into the subcutaneous layer and the needle tip was pointed toward the myofascial trigger point. Outcomes: The following outcome measurements were observed before and after treatment, including numerical rating scale, Barrow Neurology Institute Pain Scale scores, Constant Face Pain Questionnaire scores, Brief Pain Inventory-Facial scores, Patient Global Impression of Change scores, and medication dosage. The follow-up surveys were made after 2 and 4 months respectively. The pain of Case 1 was significantly reduced after 7 times FSN treatments and the pain of Case 2 was even disappeared after 6 times FSN treatments. Lessons: This case report suggested that FSN can relieve postsurgical trigeminal neuralgia safely and effectively. Clinical randomized controlled studies are needed to be further conducted.

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Patient reported outcome measures in trigeminal neuralgia – A systematic review of psychometric performance

Abstract: This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Cited by 13 publications

References 39 publications

Outcome Comparison of Drug-Resistant Trigeminal Neuralgia Surgical Treatments—An Umbrella Review of Meta-Analyses and Systematic Reviews

Outcome Comparison of Drug-Resistant Trigeminal Neuralgia Surgical Treatments—An Umbrella Review of Meta-Analyses and Systematic Reviews

An international Delphi survey and consensus meeting to define the core outcome set for trigeminal neuralgia clinical trials

Treatment of postsurgical trigeminal neuralgia with Fu’s subcutaneous needling therapy resulted in prompt complete relief: Two case reports

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