**5. Validity of allodynia testing in pelvic pain**

In order to have faith in allodynia, it is important to ensure the test has reliability. In a cohort of 81 women with chronic pelvic pain, the presence of allodynia was significantly associated with those who were suffering from visceral disease [13].

The positive predictive values for pelvic visceral disease were as follows:


The likelihood ratio (+) and 95% C.I. for the detection of visceral sources of pain were as follows:


In another study of validity, a total of 22 females with chronic pelvic pain were compared to 23 pain-free controls and 12 cyclic pain patients. Participants were evaluated by two clinicians. Investigators mapped the abdomen with the cottontipped applicator, outlined the areas of allodynia with a body pen, photographed the abdomen, and wiped off the marking before the second investigator repeated the test. The interrater reliability resulted in 98% agreement for the three study

groups. The cotton-tipped applicator test showed 73% sensitivity and 100% specificity for differentiating patients with chronic pelvic pain from pain-free patients [14]. At present, there do not appear to be pain-testing techniques that specifically identify endometriosis independent from other visceral diseases. It is arguable, however, that the experience of pain may have greater relevance depending on the clinical situation as described in relation to the negative laparoscopy.
