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Neurology
Protocol
Clinical indicators to identify neuropathic pain in low back-related leg pain: protocol for a modified Delphi study
  1. Jai Mistry1,2,
  2. Deborah Falla2,
  3. Tim Noblet1,2,
  4. Nicola R Heneghan2,
  5. Alison B Rushton2
  1. 1 Physiotherapy, St Georges Hospital NHS Foundation Trust, London, UK
  2. 2 Centre of Precision Rehabilitation for Spinal Pain, School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
  1. Correspondence to Dr Alison B Rushton; a.b.rushton{at}bham.ac.uk

Abstract

Introduction Neuropathic low back-related leg pain (LBLP) can be a challenge to healthcare providers to diagnose and treat. Accurate diagnosis of neuropathic pain is fundamental to ensure appropriate intervention is given. However, to date there is no gold standard to diagnose neuropathic LBLP. A Delphi study will therefore be conducted to obtain an expert-derived consensus list of clinical indicators to identify a neuropathic component to LBLP.

Methods/analysis Included participants will be considered experts within the field as measured against a predefined eligibility criterion. Through an iterative multistage process, participants will rate their agreement with a list of clinical indicators and suggest any missing clinical indicators during each round. Agreement will be measured using a 5-point Likert scale. Descriptive statistics will be used to measure agreement; median, IQR and percentage of agreement. A priori consensus criteria will be defined for each round. Data analysis at the end of round three will enable a list of clinical indicators to be derived.

Ethics and dissemination Ethical approval was gained from the University of Birmingham (ERN_19-1142). On completion of the study, findings will be disseminated in a peer-reviewed journal and presented at relevant conferences.

  • neurological pain
  • neuropathic pain
  • leg pain
  • diagnosis
  • Delphi
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjopen-2019-033547

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    Footnotes

    • Twitter @Deb_Falla, @HeneghanNicola, @abrushton

    • Contributors All authors devised the focus of this Delphi study. JM is a MRes student, AR is the lead supervisor, DF and NH are co-supervisors and TN is a co-researcher. JM drafted the initial protocol manuscript with lead and co-supervisors providing guidance on methodological decisions and proposed analyses. All authors have contributed subject-specific expertise. JM and TN will recruit participants into the study. All authors will contribute to data interpretation, conclusions and dissemination. All authors have read, contributed to and agreed to the final manuscript. AR is the guarantor of the study.

    • Funding It will be conducted as part of a MRes research project though the University of Birmingham.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.