Validation of a self-report measure for diagnostic screening and assessment in complex regional pain syndrome
Pain Rep. 2026 Apr 3;11(3):e1410. doi: 10.1097/PR9.0000000000001410. eCollection 2026 Jun.
ABSTRACT
INTRODUCTION: Complex regional pain syndrome (CRPS) is an orphan condition with no interventions proven effective in large-scale clinical trials. In-person clinical evaluations are required to make a CRPS diagnosis and determine study eligibility, making recruitment for CRPS trials challenging.
OBJECTIVES: We developed and validated a self-report measure of CRPS symptoms suitable for remote administration.
METHODS: We evaluated diagnostic accuracy of a self-report version of the CRPS Severity Score (CSS-SR) and assessed its validity relative to the original clinician-completed CSS (CSS-Clinician) in two samples: 112 postsurgical patients with total knee arthroplasty and 80 patients with CRPS and non-CRPS limb pain attending a chronic pain clinic. All patients completed the CSS-SR and underwent a semi-structured history and physical examination from which the CSS-Clinician was scored and a criterion-based Budapest CRPS diagnosis was determined.
RESULTS: There was good to excellent correspondence (intraclass correlations [ICCs]) between CSS-Clinician and CSS-SR total scores (postsurgical sample: ICCs = 0.86-0.92; pain clinic sample: ICC = 0.76). In the postsurgical sample, the 2 measures displayed good agreement regarding changes in CRPS features across 2 assessments 4 months apart (ICC = 0.84). The CSS-SR exhibited high diagnostic accuracy in receiver operating characteristic analyses (area under the curve = 0.84-0.94). In the pain clinic sample, a CSS-SR cutoff of ≥8 had a 79% probability of correctly predicting a Budapest CRPS diagnosis after full evaluation (sensitivity = 0.79, specificity = 0.79).
CONCLUSION: The CSS-SR appears valid as a self-report measure of CRPS status and displays good accuracy as a remote diagnostic screening tool.
PMID:41958857 | PMC:PMC13056463 | DOI:10.1097/PR9.0000000000001410