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Spinal Cord Injury Pain Instrument (SCIPI)
Availability
Please visit this website for more information about the instrument: Spinal Cord Injury Pain Instrument
Classification
Supplemental: Spinal Cord Injury (SCI)
Short Description of Instrument
The Spinal Cord Injury Pain Instrument (SCIPI) was developed as a screening tool for differentiating neuropathic pain (NP) versus non-neuropathic pain (NNP) in individuals with SCI. The SCIPI can be self-administered or via an interviewer. (Bryce et al., 2014) Originally the tool consisted of seven characteristics associated with NP after SCI. Items 1-3 concern pain descriptors that are most commonly associated with NP after SCI. The fourth item addresses the presence of pain evoked by dynamic touch; the fifth item concerns exacerbating and ameliorating factors of NP; and the sixth item relates to the temporal presence of pain. The seventh and final item identifies pain that is felt in insensate areas. (Bryce et al., 2014)
 
The SCIPI was reduced from seven items to four items (items #1-3 and #7). These items were found to be the most relevant indicating the presense of NP. (Bryce et al., 2014; Franz et al., 2017)  
 
Scoring and Psychometric Properties
Scoring:
 
The SCIPI is a 4-item yes/no questionnaire suggesting neuropathic pain in people with SCI. (Bryce et al., 2014) The items concern sensations of electric shock, tingling or pins and needles, hot/burning or cold/freezing, and whether or not the pain occurs in an insensate area of the body. These 4 items are thought to be associated with NP. (Bryce et al., 2014)
 
A score of 1 is given for a positive answer; a score of 0 is given for a negative answer. The total score is calculated as a sum 4 items with a score of 0 indicating non-NP, 1 indicating possible NP, and 2 or greater indicating probable NP. (Bryce et al., 2014) Note: non-NP includes nociceptive or pain that occurs when there is no identifiable noxious stimulus nor any detectable damage to the nervous system to which the pain can be attributed. (Bryce et al., 2014)
 
Psychometric Properties:
 
Validity: Four of the SCIPI items correlated significantly with the NP subtype as determined by the clinician. The best cutoff score for identifying NP was an endorsement of two or more of these four items. Using this cutoff, sensitivity of the SCIPI was 78%, specificity was 73% and overall diagnostic accuracy was 76%. (Bryce et al., 2014) Four of the original seven SCIPI items were very clearly correlated with International Association for the Society for Pain (IASP) classifications by the CCs (P<0.05), whereas three items did not correlate at all (P>0.6) (Bryce et al., 2014). Franz et al., 2017 demonstrated the applicability and validity of the SCIPI using the current IASP-grading as a reference standard.
Rationale/Justification
Strengths/Weaknesses: The SCIPI can be interviewer or self-administered. (Bryce et al., 2013, 2014) and may serve as a screening tool for NP after SCI. Further study is needed to determine the psychometric qualities (i.e., reliability and responsiveness) of the SCIPI. (Bryce et al., 2014)
References
Key Reference:  
 
Bryce TN, Richards JS, Bombardier CH, Dijkers MP, Fann JR, Brooks L, Chiodo A, Tate DG, Forchheimer M. Screening for neuropathic pain after spinal cord injury with the spinal cord injury pain instrument (SCIPI): a preliminary validation study. Spinal Cord. 2014;52(5):407-412.   
 
Additional References:   
 
Bryce T, Richards JS, Dijkers M, Brooks, L, Fann JR, Bombardier C, Chiodo, T, Tate D. Poster 20 Preliminary Validation of the Spinal Cord Injury Pain Instrument (SCIPI), a Neuropathic Pain Screening tool. Arc Phys Med Rehabil. 2013. Available at: https://www.archives-pmr.org/article/S0003-9993(13)00717-X/pdf.  
 
Franz S, Schuld C, Wilder-Smith EP, Heutehaus L, Lang S, Gantz S, Schuh-Hofer S, Treede RD, Bryce TN, Wang H, Weidner N. Spinal Cord Injury Pain Instrument and painDETECT questionnaire: Convergent construct validity in individuals with Spinal Cord Injury. Eur J Pain. 2017;21(10):1642-1656.   
 
WiderstrÖm-Noga E, Anderson KD, Perez S, Martinez-Arizala A, Cambridge JM. Subgroup Perspectives on Chronic Pain and Its Management After Spinal Cord Injury. J Pain. 2018;19(12):1480-1490.
 
Document last updated November 2021