Department of Obstetrics and Gynecology, University of Rochester School of Medicine and Dentistry, Rochester, New York.
To estimate the usefulness of the Short-Form McGill Pain Questionnaire (MPQ) pain descriptors in the diagnostic evaluation of chronic pelvic pain.
Design: Retrospective cohort study (Canadian Task Force classification II-2).
Setting: University-based center specializing in chronic pelvic pain.
Patients: Three hundred thirty-one consecutively evaluated women with chronic pelvic pain who had data sufficient for evaluation.
The relationships between MPQ pain descriptors and subsequent diagnoses were evaluated using odds ratios, sensitivity, specificity, and positive and negative predictive values.
The most common diagnoses were endometriosis, interstitial cystitis and painful bladder syndrome, and irritable bowel syndrome. Seventy-one percent of the patients had more than one diagnosis. Relative risks for pain descriptors as diagnostic tools for specific diagnoses were most significant, with "cramping" for endometriosis (4.0), "cramping" for interstitial cystitis and painful bladder syndrome (2.0), "sickening" for irritable bowel syndrome (1.5), and "aching" for abdominal myofascial pain syndrome (4.27).
Several of the MPQ descriptors had high negative predictive values but not high positive predictive values, which suggests that they have diagnostic usefulness in excluding but not predicting pelvic pain-related diagnoses. This was especially the case with cramping as an MPQ descriptor in women with endometriosis. However, overall the MPQ descriptors were not robust as diagnostic tools, which suggests that inclusion of the MPQ descriptors in the evaluation of women with chronic pelvic pain is of limited diagnostic value.
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Reference: J Minim Invasive Gynecol. 2011 Mar-Apr;18(2):211-7.