• Boaz Gedaliahu Samolsky Dekel, Francesca Remondini, Alberto Gori, Alessio Vasarri, GianFranco Di Nino, and Rita Maria Melotti.
• University of Bologna, Department of Medicine and Surgery Sciences, Via Massarenti n. 9, Bologna, 40138, Italy; Azienda Ospedaliera-Universitaria di Bologna Policlinico S. Orsola-Malpighi, Via Massarenti n... more . 9, Bologna, 40138, Italy; University of Bologna, Post Graduate School of Anaesthesia and Intensive Care, Via Massarenti n. 9, Bologna, 40138, Italy. Electronic address: boaz.samolskydekel@unibo.it. less
• Clin Neurol Neurosurg. 2016 Feb 1; 141: 23-9.

Background/ObjectiveBreakthrough pain (BTP) shows variable prevalence in different clinical contexts of cancer and non-cancer patients. BTP diagnostic tools with demonstrated reliability, validation and prognostic capability are lacking. We report the development, psychometric and validation properties of a diagnostic/prognostic tool, the IQ-BTP, for BTP recognition, its likelihood and clinical features among chronic-pain (CP) patients.Patientsn=120 consecutive mixed cancer/non-cancer CP in/outpatients. Development, psychometric analyses and formal validation included: Face/Content validity (by 'experts' opinion and assessing the relationship between the IQ-BTP classes and criteria derived from BTP operational-case-definition); Construct validity, by Principle Component Analysis (PCA); and the strength of Spearman correlation between IQ-BTP classes and the Brief Pain Inventory (BPI) items; Reliability, by Cronbach's alpha statistics. Associations with clinical/demographic moderators were assessed applying χ(2) analysis.ResultsPotential-BTP was found in 36.7% of patients (38.4% of non-cancer and 32.4% of cancer patients). Among these the likelihood for BTP diagnosis was 'high' in 25%, 'intermediate' in 41% and, 'low' 34% of patients. Analyses showed significant differences between IQ-BTP classes and between the latter BPI pain-item scores. Correlation between IQ-BTP classes and BPI items was moderate. PCA and scree test identified 3 components accounting for 62.3% of the variance. Cronbach's alpha was 0.71.ConclusionsThe IQ-BTP showed satisfactory psychometric and validation properties. With adequate feasibility it enabled the allocating of cancer/non-cancer CP patients in three prognostic classes. Results are sufficient to warrant a subsequent impact study of the IQ-BTP as prognostic model and screening tool for BTP in both CP populations.Copyright © 2016 Elsevier B.V. All rights reserved.

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