Clinimetric evaluation of peripheral neuropathy measurement approaches

Chemotherapy-induced peripheral neuropathy (CIPN) is a common side effect of neurotoxic chemotherapy. Chemotherapy dose reductions, neuropathy-related pain, functional deficits, and diminished quality of life are common consequences. Despite these consequences, CIPN has not been brought to the forefront due to the absence of simple clinical measures with established reliability and validity.; The main purpose of this research was to assess the clinimetric properties of several neuropathy measurement approaches. A secondary goal was to refine existing measures into reliable and valid tools for use by oncology clinicians.; One hundred seventeen oncology outpatients receiving neurotoxic drugs from taxane and platinum classes were enrolled. Participants underwent a one time assessment utilizing a five-item variant of the Total Neuropathy Score-reduced (TNSr), the six-item neuropathy-specific Neuropathic Pain Scale (NPS(c)-CIN), and the National Cancer Institute Common Terminology Criteria version 3.0 (NCI-CTC v. 3.0). Fifteen subjects underwent TNSr assessments by two separate raters.; Factor analysis of modified TNSr-Shortform (TNSr-SF) and the NPS(c)-CIN yielded two factors labeled neuropathy sensibility and pain. Cronbach's alpha for the two instruments were .80 and .96, respectively. Interrater reliability of TNSr was demonstrated. TNSr scores were higher in patients receiving higher total chemotherapy cumulative doses and greater doses by square meters of body surface area (M2), but NPS(c)-CIN scores were not. Tendon reflex scores were worse in patients receiving higher cumulative and M2 dosages. TNSr, NPS(c)-CIN, strength and pain sensibility scores, as well as NCI-CTC sensory and motor grades were worse in patients at higher risk due to diabetes, peripheral vascular disease, and/or a history of alcohol abuse. There was no difference in scores from any measure based on the number or class of neurotoxic drugs received. NCI-CTC sensory scores were higher in patients receiving higher cumulative, but not higher M 2 chemotherapy dosage. Motor scores did not significantly differ by cumulative or M2 dosage. Only the sensory CTC correlated with neuropathy and neuropathic pain measures.; CIPN and neuropathic pain measures were refined and simplified, and their reliability and validity in the studied population was demonstrated. The TNSr-SF and the NPS(c)-CIN were found to have high clinical utility, and are preferred over the NCI-CTC.