A case vignette study to assess the knowledge of pain physicians of neuropathic cancer pain: room for improvement.

BACKGROUND In more and more countries, a specific pain education curriculum is provided to instruct pain physicians. However, there is little literature on pain education and in particularly how to evaluate their knowledge. One of the modules interesting to assess is the use of clinical practice guidelines (CPGs) by pain physicians. OBJECTIVES The aim was to investigate if a case vignette is useful to evaluate pain physicians' knowledge about recommendations contained in CPGs. SETTING An email survey was conducted with the support of the Societe Francaise d'Etude et de Traitement de la Douleur to all pain specialists (primary and secondary care) in France. METHODS The survey consisted of a case vignette about a patient with pain suffering from an intractable pancreatic cancer with multiple choice questions about diagnosis and treatment of pain. Percentages of participants who treated the patient as suggested in the CPGs were calculated. RESULTS A total of 214 of those invited to participate (921) answered the questionnaire (24%). More than 85% of the respondents declared to know and use CPGs. Half of the participants diagnosed and treated neuropathic pain components in the case vignette according to the recommendations in the CPGs. LIMITATIONS This exercise needed to be explained: pain physicians should be trained to this kind of questionnaire. It explains the low response rate and the progressive diminution of responders during the questionnaire. CONCLUSIONS Case vignette is an interesting instrument for pain education because it is cheap, easy to use, and can be repeated. However, training before using this instrument is needed for pain physicians, in particular during their pain education.