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Papers of the Week

Papers: 6 Jun 2020 - 12 Jun 2020


Human Studies

2020 Jun

PLoS Med



Chronic pain diagnosis in refugee torture survivors: A prospective, blinded diagnostic accuracy study.


Kaur G, Weinberg R, Milewski A R, Huynh S, Mauer E, Hemmings H C, Pryor K O
PLoS Med. 2020 Jun; 17(6):e1003108.
PMID: 32502219.


An estimated 87% of torture survivors experience chronic pain such as brachial plexopathy from upper extremity suspension or lumbosacral plexus injury from leg hyperextension. However, a vast majority of pain is undetected by evaluators due to a lack of diagnostic tools and confounding psychiatric illness. This diagnostic gap results in exclusive psychological treatment rather than multimodal therapies, substantially limiting rehabilitation. We hypothesized that the United Nations Istanbul Protocol (UNIP) would have a sensitivity of approximately 15% for pain detection, and that the use of a validated pain screen would improve its sensitivity by at least 29%, as compared to the reference standard (pain specialist evaluation).