Interrater reliability of diagnosing complex regional pain syndrome type I

Roberto S.G.M. Perez, P. E.T. Burm, W. W.A. Zuurmond, M. J.M.M. Giezeman, N. T. Van Dasselaar, J. Vranken, J. J. De Lange

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Background: Diagnosis of complex regional pain syndrome type I (CRPS I) is based on clinical observation of symptoms. As little information is available on the reliability of CRPS I diagnosis, we evaluated the agreement between therapists with regard to the presence and severity of CRPS I and its symptoms. Methods: The interrater reliability was evaluated in 37 presumed CRPS I patients by three observers; one consultant anesthesiologist and two resident anesthesiologists. Patients were assessed on the basis of Veldman's CRPS criteria. Results: The interrater reliability for diagnosing CRPS I was good for the majority of observer combinations. The percentage of agreement for the absence or presence of CRPS I was good (88%-100%). Cohen's Kappa's ranged from 0.60 to 0.86. The agreement for the mean symptom score ranged from 70.2% to 88.6%; Kappa's were lower and showed more variation. Interrater reliability for assessment of the severity of CRPS I and its symptoms was poor. Factors influencing the interrater reliability were symptom type, individual observers and sample population. Conclusion: Diagnosing CRPS I can be performed on the basis of clinical observation. Further assessment of severity of CRPS I and its symptoms should be performed with reliable and valid measurement instruments.

Original languageEnglish
Pages (from-to)447-450
Number of pages4
JournalActa anaesthesiologica Scandinavica
Issue number4
Publication statusPublished - 1 Jan 2002


  • CRPS type I
  • Diagnosis
  • Interrater reliability
  • Severity

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