Estimating the prevalence of chronic pain: Validation of recall against longitudinal reporting (the HUNT pain study)

Abstract

Methods for classifying chronic pain in population studies are highly variable, and prevalence estimates ranges from 11% to 64%. Limited knowledge about the persistence of pain and the validity of recall questions defining chronic pain make findings difficult to interpret and compare. The primary aim of the current study was to characterize the persistence of pain in the general population and to validate recall measures against longitudinal reporting of pain. A random sample of 6419 participants from a population study (the HUNT 3 study in Norway) was invited to report pain on the SF-8 verbal pain rating scale every 3 months over a 12-month period and to report pain lasting more than 6 months at 12-month follow-up. Complete data were obtained from 3364 participants. Pain reporting was highly stable (intraclass correlation 0.66, 95% confidence interval 0.65 to 0.67), and the prevalence of chronic pain varied considerably according to level of severity and persistence: 31% reported mild pain or more, whereas 2% reported severe pain on 4 of 4 consecutive measurements. When defined as moderate pain or more on at least 3 of 4 consecutive measurements, the prevalence was 26%. Compared with the longitudinal classification, a cross-sectional measure of moderate pain or more during the last week on the SF-8 scale presented a sensitivity of 82% and a specificity of 84%, and a sensitivity of 80% and a specificity of 90% when combined with a 6-month recall question. Thus pain reporting in the general population is stable and cross-sectional measures may give valid prevalence estimates of chronic pain.

Chronic Pain and DepressionAmong Primary Care Patients Treated with Buprenorphine

“…44,45 To assess pain severity, we asked participants to rate their average overall pain in the past week on a 0-100 scale, with 0 being no pain and 100 being pain Bas bad as you can imagine.^4 4 We defined three groups: no chronic pain (some of whom had acute pain lasting less than 6 months), mild chronic pain (i.e., pain severity between 0 and 39 in the past week, and pain for at least 6 months) moderate/severe chronic pain (i.e., pain severity was ≥ 40 in the past week and pain for at least 6 months). We chose this cutoff based on its use as a threshold for inclusion in clinical trials of analgesics.…”

Qualitative Investigation of a Brief Chronic Pain Screening Tool in HIV-Infected Patients

“…15 Based on the results of a systematic process of qualitative cognitive interviewing in HIV-infected patients, including persons with mood disorders and substance use, we assert that the BCPS may be used without modification or adaptation to screen for chronic pain in this population. This tool should enable further research on the clinical epidemiology and management of chronic pain in HIV-infected patients using the BCPS.…”

“…Summary statistics were presented using the cutoff of at least moderate chronic pain for at least 3 months established in the original study of the BCPS. 15 …”

“…However, it must also meet the challenge of identifying individuals with a heterogeneous condition. The types and patterns of pain experienced by individuals with chronic pain vary widely, 15 and accordingly, the consensus definition of chronic pain remains inclusive. 3,16 If continuous pain from fibromyalgia and intermittent pain from arthritis both qualify as chronic pain, then a useful screener may have to reach for breadth at the expense of specificity.…”

“…15 It asks, ''How much bodily pain have you had during the last week?'' (none, very mild, mild, moderate, severe, very severe), and ''Do you have bodily pain that has lasted for more than 6 months?''…”