New Findings on Risk Factors for Postherpetic Neuralgia From 2014 to 2024: A Systematic Review and Meta-Analysis
Bibliographic record
Abstract
Background: Postherpetic neuralgia (PHN) is a significant public health issue that severely impacts patients’ quality of life. This systematic review is the first to conduct a meta-analysis of newly identified risk factors for PHN over the past decade, evaluating the temporal changes in these risk factors to assist clinicians in predicting the occurrence of PHN. Methods: Cohort and case-control studies on PHN risk factors were retrieved from PubMed, Web of Science, Embase and Cochrane Library (January 1, 2014–March 26, 2024). Study quality was assessed using the Agency for Healthcare Research and Quality (AHRQ) or the Newcastle-Ottawa Scale (NOS). Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated to assess risk factor effects. Results: Seventeen studies involving 124,078 participants were included, identifying 81 potential risk factors. Eleven factors were meta-analyzed, and significant risk factors among these included age (age 60– 69 (OR=2.05, 95% CI=[1.92,2.19], P < 0.00001, I2 =0%, age over 70 (OR=3.08, 95% CI=[2.89,3.29], P < 0.00001, I2 =0%)), severe rash (OR=2.69, 95% CI=[1.23,1.88], P =0.01, I2 =0%), acute pain severity (OR=2.01, 95% CI=[1.28,3.15], P =0.002, I2 =21%), anxiety/depression (OR=1.30, 95% CI=[1.21,1.41], P < 0.00001, I2 =0%), diabetes mellitus (OR=1.46, 95% CI=[1.40,1.53], P < 0.00001, I2 =28%), malignancy (OR=1.56, 95% CI=[1.23,1.99], P =0.0002, I2 =25%), chronic obstructive pulmonary disease(COPD) (OR=1.88, 95% CI=[1.79,1.98], P < 0.00001, I2 =0%), hypertension (OR=1.22, 95% CI=[1.12,1.32], P < 0.00001, I2 =2%) and peptic ulcer (OR=3.71, 95% CI=[2.31,5.96], P < 0.00001, I2 =0%). Female sex (OR=0.69, 95% CI=[0.47,1.01], P = 0.06, I2 =15%) and inflammatory factors (OR=1.01, 95% CI=[0.98,1.04], P =0.45, I2 =30%) were not statistically significant. Conclusion: COPD, hypertension, anxiety/depression, malignancy and peptic ulcers may represent newly identified PHN risk factors. Given the limitations of the research, the results should be interpreted with caution. Future research should focus on these factors to enhance clinical prediction and prevention strategies. Trial Registration: This study is registered in the PROSPERO database (No. CRD42024543589). Keywords: postherpetic neuralgia, risk factors, meta-analysis
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.013 | 0.010 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.009 | 0.004 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".