Authors' objectives: To determine whether there is any impact on applying “at the time of evaluation” statement in establishing Complex Regional Pain Syndrome (CRPS) diagnostic to the available signs (and symptoms) especially those proposed in the Budapest Criteria, to the outcome of treatments.

Authors' results and conclusions: 70 published studies were identified from the literature searches. Upon examination on the titles and abstracts of these 70 studies, seven studies were thought to be relevant and were retrieved in full for further appraisal. Manual searches adding further 16 published studies. Hence, overall, 23 studies were retrieved in full for further appraisal in this systematic review. Of the 23 studies that were retrieved in full, none provided any data emphasizing the practice of investigating/establishing the signs and symptoms, regardless of the diagnostic criteria employed in the study, at the time of evaluation/visit/diagnostic especially in associating this practice to the outcomes of the study. It should be noted that some of the studies that listed the diagnostic criteria employed clearly stated that signs were displayed at the time of evaluation. The proposed/original version of the Budapest criteria stated that the signs that a patient was required to display at the time of evaluation were “counted only if observed at time of diagnosis”. At present, there is no empirical data reporting the differences in emphasizing that diagnostic criteria of CRPS, especially its signs, had to be observed at the time of evaluation as opposed to those reported as “added-up”. However, it should be noted that some studies clearly emphasized that CRPS signs had to be observed at the time of evaluation and the original Budapest criteria strictly stated that “signs counted only if observed at time of diagnosis”.

Authors' methods: A broad, comprehensive and systematic literature search was conducted on May 21, 2025. The search was done on commercial medical literature databases where a combination of keywords was employed. No limitation, such as on the language or date of publication, was implemented in any of these searches. A manual search was also done on the references of the articles retrieved in full as well as on the EBPG’s article collection on CRPS that we maintain since 2002.

Project Status: Completed

URL for project: https://www.worksafebc.com/en/about-us/research-services/evidence-based-medicine-and-systematic-reviews

Year Published: 2025

URL for published report: https://www.worksafebc.com/en/resources/health-care-providers/guides/crps-diagnostic-criteria-at-time-of-evaluation-its-role-on-treatment-outcomes?lang=en&origin=s&returnurl=https%3A%2F%2Fwww.worksafebc.com%2Fen%2Fforms-resources%23sort%3DDate%26q%3DComplex%2520Regional%2520Pain%2520Syndrome%2520(CRPS)%2520Diagnostic%2520Criteria%2520at%2520Time%2520of%2520Evaluation%2520and%2520its%2520Role%2520on%2520Treatment%2520Outcomes%26f%3Alanguage-facet%3D%5BEnglish%5D%26tags%3DGuide%7C2d7eb4b30f6a4a319e0d40565c9abbab%2CHealth%2520Care%2520Provider%7C13468b0b3f074f6bade3f57ac3cdfb8e%2CSystematic%2520Review%7Cf78c29d570c14ec3b5a394385905df70&highlight=Complex%20Regional%20Pain%20Syndrome%20(CRPS)%20Diagnostic%20Criteria%20at%20Time%20of%20Evaluation%20and%20its%20Role%20on%20Treatment%20Outcomes

English language abstract: An English language summary is available

Publication Type: Mini HTA

Country: Canada

Organisation Name: WorkSafeBC

Contact Address: 6591 Westminster Highway, Richmond, BC, V7C 1C6 Canada. Tel: 604-231-8417; Fax: 604-279-7698

Contact Name: ebpg@worksafebc.com

Contact Email: ebpg@worksafebc.com

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