Different Types of Pain in Patients With Gout, Research Paper Example

Descriptive analyses were used to describe the main features of the participants that were involved in the study. Variables were expressed as numbers and percentages for categorical data, means and standard deviations for normally distributed continuous data and medians with interquartile ranges for non-normally distributed data.

The two main variables were; Neuropathic pain and the physical functioning measured by the Health Assessment Questionnaire-Disability Index (HAQ-DI).

The normality of the HAQ-DI was examined graphically and later tested with the Shapiro-Wilk test of normality where the results indicated a non-significant p-value (p< 0.05), for normally distributed data (p>0.05). The differences in HAQ-DI scores between the patients classified as either negative, unclear or positive for neuropathic pain on the pain-DETECT were examined using the non-parametric Kruskal-Wallis H test due to the distribution of the HAQ-DI scores. Using the bivariate correlation analysis the association between the total pain detect scores and the HAQ-DI scores. The differences between groups were tested with Post hoc Mann-Whitney u test.

To the above test statistical significance lies in on 95% confidence level or 5% significance level (p-value <0.05).

Patient characteristics

In total, 98 patients completed the survey. 12 (12.6%) of the respondents were female, and 83 (87.4%) were male, giving a total of 95 of the respondents’ gender was known and 3 missing. The mean age of the respondents was 68.92 with a standard deviation of 11.897 was considered, indicating that the majority of the respondents were between 57 and 81 years. The data showed that 6 patients (6.1%) were current smokers. Current alcohol use was reported by 67 (68.4%) patients while 31 (31.6%) of the respondents did not use alcohol. With respect to Comorbidities, 33 (33.7%) of the respondents reported osteoarthritis, 20 (20.4%), Rheumatoid arthritis, and 6 (6.1%) Fibromyalgia. 85 patients (88.5%) used urate-lowering therapy (ULT) and 55 (57.3%) used Colchine. 44 (44.9%) of the respondents reported that they used paracetamol as self-reported current medication, while 18 (18.4%) use NSAIDs, and 5 (5.1%) use Opioid. On the self-reported anti-inflammatories, 86 (87.8%) of the respondents reported that they don’t use it, 11 (11.2%) use Predmison, and 1 (1.0%) use Dexamethasone. One patient (1.0%) self-reported anti-depressants use (Nortriptyline) and one (1.0%) self-reported Anticonvusant use (Gabapetin).

Association between pain type and physical disability

The pain-DETECT was measured on three levels; Negative, Unclear, and Positive.

In total, 48 (51.6%) of the respondents scored were negative for neuropathic pain, 26 (28.0%) scored unclear and 19 (20.4%) scored positive for neuropathic pain (Table 2). It is thus evident that a larger percentage of the participants happen to fall under the negative sub-group.

The following graph shows the histogram of the HAQ-DI with the normal curve superimposed on it to assess the normality.

Test for Normality of HAQ

The output shows that the tail of the normal curve is heavy on the right, indicating that the distribution scores on the HAQ-DI are skewed to the right. Hence HAQ-DI is not normally distributed.

The next approach to testing the normality distribution of the scores to a variable of interest if the use of a statistic test known as Shapiro-Wilk for dataset < 2000 observations and Kolmogorov-Smirnov for observations > 2000.

Statistical Test for Normality

The Shapiro-wilk test results indicate a p-value <0.05. it is thus evident from the histogram and the Shapiro-wilk test that the HAQ-DI scores were not normally distributed.

From the descriptive, the study shows that there is different in the frequency on the issue of pain detection and the measure of physical functioning and since the dependent variable HAQ-DI is not normally distributed, we fail to use ANOVA unless under transformation, therefore, the study will use the Kruskal-Wallis H test to test if patients with neuropathic pain report poor physical functioning. The hypothesis on which the study will be based is indicated as follows.

Hypothesis Tes

The results shows that the frequency and the mean rank, respectively, for the respondents who reported negative 48 (38.28), unclear 26 (44.02) and Positive 18 (72.00). According to the Kruskal-Wallis H test there is a statistical difference in physical functioning on people with gout experiencing NP.

For the post-hoc test p-value=0.001, for the negative the correction would be 0.00002, unclear =0.000038 and positive it is 0.000056. it is thus evident that the positive group exhibits more correlation I comparison with the other groups.

Correlation Test

Correlation between neuropathic pain and physical functioning

The need to check for the correlation between the two variables of interest, i.e., Pain-DETECT and HAQ_DI

From table 5, there is a positive moderate correlation between Neuropathic Pain (NP) and Physical disability (r = 0.485; P < 0.05).

To examine characteristics Univariate linear regression analysis were performed, next multiple linear regression was performed to identify unique association

Higher pain intensity, lower quality of life and more disability were associated with higher pain detect score.

Multivariate Regression

Table 6: Multivariate linear Regression of physical disability

R² = …

Table 6 shows the regression and the significance of other factors apart from neuropathic pain to the physical functioning. Having comorbid osteoarthritis was independently associated with higher psychical disability scores while not using alcohol was associated with lower disability scores.