Presented at the 2013 AAPM Annual Meeting« Back

Use of a Novel Video Pain Scale and Its Impact on the Perception of Chronic Pain

Wesley R. Prickett, MD, pioneer41@gmail.com¹, Kenneth A. Follett, MD PhD², Daniel M. Doleys, PhD³, Nicholas W. Markin, MD⁴, (1) UC Davis Medical Center, Sacramento, California, (2) University of Nebraska, Omaha, Nebraska, (3) Pain and Rehabilitation Institute, Birmingham, Alabama, (4) University of Utah, Department of Anesthesiology, Salt Lake City, Utah

Introduction: Chronic pain is multidimensional and numerous scales/questionnaires have attempted to quantify chronic pain; often the Numeric Rating Scale (NRS) and the Visual Analog Scale (VAS) are used. We designed a novel video pain scale (NVPS) that included several 2003 IMMPACT domains: 1) pain, 2) physical function and 3) emotional function to investigate which domains the patient felt most closely represented their chronic pain experience. We hypothesize that exposure to the NVPS will provide contextual points of reference and alter reported pain scores. Materials and Methods: Forty-nine consecutive subjects participated following IRB approval. Individual subjects evaluated their pain with the NRS/VAS scales and then were shown the NVPS and asked to rate their pain and asked which aspect of the video pain scale was most similar to their pain. Statistical analysis using both Pearson correlation and Spearman correlation was performed. Results: There is high correlation between the NRS and the VAS and less correlation between the NRS/VAS results and the NVPS. Only 27% of subjects identified with pain intensity while 41% identified with the impact on physical function. Discussion: Exposure to the NVPS resulted in poor correlation because we believe the reference points within the video altered the patients' perceived pain score. Also, the majority of subjects identified with impact on physical function. In this era of managed healthcare and pay for performance, this study highlights that pain intensity may not be the biggest component of chronic pain and therefore not the best measure of success. References: 1) Ohnhaus, EE, Adler, R. Methodological Problems in the Measurement of Pain: A Comparison between the Verbal Rating Scale and the Visual Analogue Scale. Pain: 1975; 379-384. 2) Dworkin RH, Turk DC, Farrar JT, et al. Core Outcome Measures for Chronic Pain Clinical Trials: IMMPACT Recommendations. Pain 2005 3) Jensen MP. Questionanaire Validation: A Brief Guide for Readers of the Research Literature. Clin. J. Pain 2003.

Funding: None

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