Publicação
Interrater reliability of a manual diagnostic protocol for pancreatic functional visceral dysfunction
| datacite.subject.fos | Ciências Médicas | |
| datacite.subject.sdg | 04:Educação de Qualidade | |
| dc.contributor.author | Faria, Miguel | |
| dc.contributor.author | Machado, Nuno | |
| dc.contributor.author | Sousa, Marcos | |
| dc.contributor.author | Pires, Patrícia | |
| dc.contributor.author | Pires, Telma | |
| dc.date.accessioned | 2026-03-30T09:28:52Z | |
| dc.date.available | 2026-03-30T09:28:52Z | |
| dc.date.issued | 2026 | |
| dc.description.abstract | A reliable manual examination has not been validated as a diagnostic tool for nociplastic visceral pain. Aims: To establish the interrater reliability of a manual examination protocol for functional pancreatic visceral dysfunction and the clinical criteria for a manual palpatory diagnosis based on the clinical features of the noci- plastic visceral pain. Methods: This double-blind cross-sectional study involved 60 participants assessed by three raters using a manual protocol for diagnosing functional pancreatic visceral dysfunction. Five palpation-based criteria were evaluated: (1) local pain, (2) referred pain, (3) neurovegetative symptoms, (4) hyperalgesia or allodynia, and (5) tissue resistance/density. Interrater agreement was measured using percentage agreement and Fleiss’ kappa. The reliability of the Verbal Numerical Rating Scale (vNRS) was assessed using the intraclass correlation coef - cient (ICC). Repeated measures analysis of variance and Cochran’s Q test (with Bonferroni correction) were used to analyze vNRS scores and categorical outcomes, respectively. Signi cance was set at p < 0.05. Results: Criteria 1, 3, and 4 showed particularly high levels of agreement, with overall agreement percentages of 93.3%, 95.6%, and 95.6%, respectively. The corresponding Fleiss’ kappa values were 0.863, 0.880, and 0.908, indicating almost perfect agreement. In contrast, Criteria 2 and 5 demonstrated substantial, but compara- tively lower, agreement, with overall percentages of 86.7% and 87.8% and Fleiss’ kappa values of 0.679 and 0.755. The vNRS demonstrated excellent reliability across all three pancreas regions, with ICC values well >0.90: head (ICC= 0.943, 95% con dence interval [CI]= 0.913–0.964), body (ICC= 0.950, 95% CI= 0.923– 0.968), and tail (ICC= 0.963, 95% CI= 0.944–0.977). Conclusions: Three blinded raters reached an almost perfect pair-wise interrater agreement on the presence or absence of functional visceral dysfunction in the topographic projection of the pancreas. This study provides pre- liminary evidence that a manual diagnostic protocol is a reliable and potentially useful diagnostic tool in diagnos- ing nociplastic pain in the topographic projection of the pancreas. Future research should prioritize evaluating the validity of the nociplastic visceral pain diagnosis. | eng |
| dc.identifier.citation | Faria, Miguel; Machado, Nuno; Sousa, Marcos; Pires, Patrícia; Pires, Telma (2025). Interrater reliability of a manual diagnostic protocol for pancreatic functional visceral dysfunction. Journal of Integrative and Complementary Medicine. ISSN 2768-3605. 32:1, p. 47-54 | |
| dc.identifier.doi | 10.1177/27683605251372011 | |
| dc.identifier.issn | 2768-3605 | |
| dc.identifier.uri | http://hdl.handle.net/10198/36374 | |
| dc.language.iso | eng | |
| dc.peerreviewed | yes | |
| dc.publisher | Sage Journals | |
| dc.rights.uri | http://creativecommons.org/licenses/by/4.0/ | |
| dc.subject | :Nociplastic pain | |
| dc.subject | Pancreas | |
| dc.subject | reliability | |
| dc.subject | Visceral pain | |
| dc.subject | Visceral osteopathy | |
| dc.title | Interrater reliability of a manual diagnostic protocol for pancreatic functional visceral dysfunction | por |
| dc.type | journal article | |
| dspace.entity.type | Publication | |
| oaire.citation.endPage | 54 | |
| oaire.citation.issue | 1 | |
| oaire.citation.startPage | 47 | |
| oaire.citation.title | Journal of Integrative and Complementary Medicine | |
| oaire.citation.volume | 32 | |
| oaire.version | http://purl.org/coar/version/c_970fb48d4fbd8a85 | |
| person.familyName | Pires | |
| person.givenName | Telma | |
| person.identifier.ciencia-id | 1B13-ADC8-08CB | |
| person.identifier.orcid | 0000-0002-1937-9167 | |
| person.identifier.scopus-author-id | 57215610713 | |
| relation.isAuthorOfPublication | 33f1c947-4e58-415b-9ebf-43d24c2228e7 | |
| relation.isAuthorOfPublication.latestForDiscovery | 33f1c947-4e58-415b-9ebf-43d24c2228e7 |