Using a worst pain intensity measure in children and adolescents

Avian, Alexander; Messerer, B.; Meißner, Winfried; Sandner‐Kiesling, Andreas; Kammel, Julian; Labugger, Marlies; Weinberg, Annelie; Berghold, Andrea

doi:10.1111/jan.13271

Cited by 4 publications

(3 citation statements)

References 79 publications

(104 reference statements)

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“…Avian et al, 2016Avian et al, , 2017. Briefly, Study 1(Avian et al, 2016) and study 2(Avian et al, 2017) were prospective studies (Study 1:between July 2010 and March 2012; study 2: between October 2013 and May 2014) that included patients between eleven and 18 years who underwent surgery at the Department of Pediatric and Adolescent Surgery, Medical University of Graz (Austria). Patients had to be able to speak German.…”

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confidence: 99%

Scaling properties of pain intensity ratings in paediatric populations using the Faces Pain Scale-revised: Secondary analyses of published data based on the item response theory

Avian

Messerer

Frey

et al. 2018

International Journal of Nursing Studies

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Scaling properties of pain intensity ratings in paediatric populations using the Faces Pain Scale-revised: Secondary analyses of published data based on the item response theory

Avian

Messerer

Frey

et al. 2018

International Journal of Nursing Studies

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“…Data availability statement: The data and R-Code that support the findings of this study are available at PsychArchives. 7,8 The data that support the findings of this study are available from the corresponding author, A.A., on reasonable request and conditionally to a proper ethical approval for a secondary data…”

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confidence: 64%

“…Data availability statement: The data and R-Code that support the findings of this study are available at PsychArchives. 7,8…”

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confidence: 99%

Numeric rating scale for pain should be used in an ordinal but not interval manner. A retrospective analysis of 346,892 patient reports of the quality improvement in postoperative pain treatment registry

Stijic,

Messerer,

Meißner

et al. 2023

Pain

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To assess postoperative pain intensity in adults, the numeric rating scale (NRS) is used. This scale has shown acceptable psychometric features, although its scale properties need further examination. We aimed to evaluate scale properties of the NRS using an item response theory (IRT) approach. Data from an international postoperative pain registry (QUIPS) was analyzed retrospectively. Overall, 346,892 adult patients (age groups: 18-20 years: 1.6%, 21-30 years: 6.7%, 31-40 years: 8.3%, 41-50 years: 13.2%, 51-60 years: 17.1%, 61-70 years: 17.3%, 71-80 years: 16.4%, 81-90 years: 3.9%, >90: 0.2%) were included. Among the patients, 55.7% are female and 38% had preoperative pain. Three pain items (movement pain, worst pain, least pain) were analyzed using 4 different IRT models: partial credit model (PCM), generalized partial credit model (GPCM), rating scale model (RSM), and graded response model (GRM). Fit indices were compared to decide the best fitting model (lower fit indices indicate a better model fit). Subgroup analyses were done for sex and age groups. After collapsing the highest and the second highest response category, the GRM outperformed other models (lowest Bayesian information criterion) in all subgroups. Overlapping categories were found in category boundary curves for worst and minimum pain and particularly for higher pain ratings. Response category widths differed depending on pain intensity. For female, male, and age groups, similar results were obtained. Response categories on the NRS are ordered but have different widths. The interval scale properties of the NRS should be questioned. In dealing with missing linearity in pain intensity ratings using the NRS, IRT methods may be helpful.

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Recommendations for selection of self-report pain intensity measures in children and adolescents: a systematic review and quality assessment of measurement properties

Birnie

Hundert

Lalloo

et al. 2018

Pain

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In 2006, PAIN published a systematic review of the measurement properties of self-report pain intensity measures in children and adolescents (Stinson JN, Kavanagh T, Yamada J, Gill N, Stevens B. Systematic review of the psychometric properties, interpretability and feasibility of self-report pain intensity measures for use in clinical trials in children and adolescents. PAIN 2006;125:143-57). Key developments in pediatric pain necessitate an update of this work, most notably growing use of the 11-point numeric rating scale (NRS-11). Our aim was to review the measurement properties of single-item self-report pain intensity measures in children 3 to 18 years old. A secondary aim was to develop evidence-based recommendations for measurement of child and adolescent self-report of acute, postoperative, and chronic pain. Methodological quality and sufficiency of measurement properties for reliability, validity, responsiveness, and interpretability was assessed by at least 2 investigators using COnsensus based Standards for the selection of health Measurement INstruments (COSMIN). Searches identified 60 unique self-report measures, of which 8 (reported in 80 papers) met inclusion criteria. Well-established measures included the NRS-11, Color Analogue Scale (CAS), Faces Pain Scale-Revised (FPS-R; and original FPS), Pieces of Hurt, Oucher-Photographic and Numeric scales, Visual Analogue Scale, and Wong-Baker FACES Pain Rating Scale (FACES). Quality of studies ranged from poor to excellent and generally reported sufficient criterion and construct validity, and responsiveness, with variable reliability. Content and cross-cultural validity were minimally assessed. Based on available evidence, the NRS-11, FPS-R, and CAS were strongly recommended for self-report of acute pain. Only weak recommendations could be made for self-report measures for postoperative and chronic pain. No measures were recommended for children younger than 6 years, identifying a need for further measurement refinement in this age range. Clinical practice and future research implications are discussed.

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Using a worst pain intensity measure in children and adolescents

Abstract: Nine to 36% of our patients showed inconsistent worst pain ratings. To overcome this problem, more specific pain intensity items, more than one item or a better instruction for pediatric patients could be used.

Cited by 4 publications

References 79 publications

Scaling properties of pain intensity ratings in paediatric populations using the Faces Pain Scale-revised: Secondary analyses of published data based on the item response theory

Scaling properties of pain intensity ratings in paediatric populations using the Faces Pain Scale-revised: Secondary analyses of published data based on the item response theory

Numeric rating scale for pain should be used in an ordinal but not interval manner. A retrospective analysis of 346,892 patient reports of the quality improvement in postoperative pain treatment registry

Recommendations for selection of self-report pain intensity measures in children and adolescents: a systematic review and quality assessment of measurement properties

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