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. 2021 Aug 18;22(1):708.
doi: 10.1186/s12891-021-04481-5.

Cross-cultural adaptation and validation of the German Central Sensitization Inventory (CSI-GE)

Michel Klute  1 , Marjan Laekeman  2 , Katrin Kuss  3 , Frank Petzke  4 , Angela Dieterich  5 , Andreas Leha  6 , Randy Neblett  7 , Steffen Ehrhardt  8 , Joachim Ulma  9 , Axel Schäfer  10
Affiliations

Cross-cultural adaptation and validation of the German Central Sensitization Inventory (CSI-GE)

Michel Klute et al. BMC Musculoskelet Disord. .

Abstract

Background: The Central Sensitization Inventory (CSI) is a screening tool designed to detect symptoms related to Central Sensitization (CS) and Central Sensitivity Syndromes (CSS) by measuring the degree of related phenomena. The objective of this study was to create a German, culturally-adapted version of the CSI and to test its psychometric properties.

Methods: A German version of the CSI (CSI-GE) was developed, culturally-adapted, and pretested for comprehensibility. The psychometric properties of the resulting version were validated in a clinical study with chronic pain and pain-free control subjects. To assess retest reliability, the CSI-GE was administered twice to a subgroup of patients. Structural validity was tested using factor analyses. To investigate construct validity a hypotheses testing approach was used, including (1) correlations between the CSI-GE and several other well-established questionnaires as well as (2) an investigation of the CSI-GE discriminative power between different subgroups of participants believed to have different degrees of CS.

Results: The CSI-GE showed excellent reliability, including high test-retest characteristics. Factor analyses confirmed a bi-factor dimensionality as has been determined previously. Analysing construct validity 6 out of 11 hypotheses (55%) were met. CSI-GE scores differentiated between subgroups according to expectations. Correlations between CSI-GE scores and other questionnaires suggested that none of the correlated constructs was identical, but there was overlap with other questionnaires based on symptom load. Several correlations did not fit with our current understanding of CS.

Conclusion: The CSI-GE appears to be a reliable tool for measuring CS/CSS-related symptomatology. Whether this implies that the CSI-GE measures the degree of CS within an individual subject remains unknown. The resulting score should be interpreted cautiously until further clarification of the construct.

Keywords: CSI; CSI-GE; Central sensitivity syndromes; Central sensitization; Central sensitization inventory; Chronic pain; Cross-cultural adaptation; Psychometric validation.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Limits of agreement – Bland Altman Plot: The difference (y-axis) = CSI-GE sum score time point 1 – CSI-GE sum score time point 2 was plotted against the mean (x-axis) = (CSI-GE sum score time point 1 + CSI-GE sum score time point 2)/2 for every patient. Line a (=0.022) represents the mean systematic difference between the two time points. Line b represents a + 1.96*standard deviation difference (=11.508). Line c represents a-1.96*standard deviation difference (= − 11.464). Therefore, lines b and c show the limits of agreement enclosing 95% of the patients in between
Fig. 2
Fig. 2
Scree plot EFA
See this image and copyright information in PMC

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